Hematuria and Renal Failure BY: Prof. Jameela Kari: CABP, MD, CCST, FRCPCH, FRCP (UK) Professor of Paediatric Nephrology Dr. Salah Al- Morshedy : M.D.& lecturer of Pediatric Nephrology. Learning objectives :. By the end of this lecture, you should know about : Hematuria
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Hematuria and Renal Failure BY:Prof.Jameela Kari:CABP, MD, CCST, FRCPCH,FRCP (UK)Professor of Paediatric NephrologyDr.Salah Al-Morshedy :M.D.& lecturer of Pediatric Nephrology
By the end of this lecture, you should know about :Hematuria
2-List types of hematuria.
3-Recognize cause of microscopic hematuria.
4-Recognize cause of macroscopic hematuria.
5-Discuss investigation of hematuria.
1-Define Renal Failure.
2-Differentiate between ARF and CRF.
3-Discuss causes of ARF.
4-Recognize the clinical presentation of ARF.
5-Discuss the diagnostic test of ARF.
6-Recognize clinical presentation of CRF.
7-Discuss the diagnostic test of CRF.
8-Describe the management of ARF and CRF.
Diagramatic explanation of renal system.
causes of hematuria (glumerulus and non glumerulus)
Non-renal (systemic) causes.
Stepwise approach for investigation.
Definition of R.F.
difference between ARF and CRF.
Explain how to differentiate between Pre-renal, renal and post-renal causes in ARF.
Investigation of ARF and CRF.
Management of ARF and CRF.
Younger children:SPA, Catheter, Bag
ARF volume overload, hypertension, fits, hyperkalemia, hyperphosphatemia, hypocalcaemia and acidosis
Management of ARF
Glomerulonephritis or vasculitis
Exclude extra-renal disorders
Dnase B titer or streptozyme < 6 months duration
Skin or throat culture
Urine analysis looking for cast
Coagulation study/ platelet count
Sickle cell screen in black patients
Microscopic haematuria plus any of the following:
Diminished renal function
Persistant microscopic haematuria (>1 year)
Second episode of gross haematuria
Pink o microscopic haematuria, dysuria and sterile urine culture
Urine osmolality exceeds 500 mOsm/kg [mmol/l] H2O.
Sodium content is usually less than 20 mEq/l (mmol/l).
The fractional excretion of sodium (urine/plasma sodium concentration divided by the urine/plasma creatinine concentration X 100) is usually less than 1%.
osmolality less than 350 mOsm/kg [mmol/l] H2O
Usually exceeds 40 mEq/l (mmol/l)
Usually exceeds 1%Urine Analysis
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