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Nephrology
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Table of Contents

Preface vii

Acknowledgements ix

How to Use This Book x

List of Abbreviations xi

Normal range for investigations xiv

Part 1 Basics 1

Basic science 1

Approach to the patient 8

Clinical overview 13

Part 2 Cases 30

Patients with Acute Renal Failure

Case 1 An 84-year-old man with reduced urine output 30

Case 2 A 74-year-old man with acute renal failure 37

Case 3 A 64-year-old man with back pain and polydipsia 45

Case 4 A 20-year-old woman with facial swelling and coke-coloured urine 51

Case 5 A 68-year-old man with hearing loss, fatigue and arthralgia 56

Case 6 A 19-year-old man with macroscopic haematuria 62

Case 7 A 27-year-old woman with a rash and renal impairment 68

Case 8 A 26-year-old man with haemoptysis and oliguria 72

Case 9 A 25-year-old woman presents with rash and joint pain 78

Case 10 An 18-year-old girl with lethargy and headache 86

Patients with Nephrotic Syndrome

Case 11 A 56-year-old man with ankle swelling 93

Case 12 An 80-year-old man with abdominal discomfort and ankle swelling 98

Case 13 A 23-year-old obese woman with ankle swelling 106

Case 14 A 15-year-old girl with facial swelling and frothy urine 113

Patients with Hypertension

Case 15 A 50-year-old woman with hypertension 117

Case 16 A 60-year-old male smoker with hypertension and renal impairment 123

Patients with Urine Dipstick Abnormalities

Case 17 A 25-year-old woman with dysuria and urine dipstick abnormalities 128

Case 18 A 40-year-old ex-intravenous drug user with protein and blood on urine dipstick 133

Case 19 A 35-year-old man with macroscopic haematuria 138

Case 20 An 82-year-old woman with dark urine 143

Acid–Base wnd Electrolyte Problems

Case 21 A 28-year-old type I diabetic man with abdominal pain and vomiting 148

Case 22 A 22-year-old man with weakness and lethargy 154

Case 23 A 58-year-old type II diabetic with confusion and hyponatraemia 159

Patients with Chronic Kidney Disease/End-Stage Renal Failure

Case 24 A 49-year-old man with headache and malaise 163

Case 25 A 23-year-old man with shortness of breath 169

Case 26 A 34-year-old man on haemodialysis 176

Case 27 A 54-year-old man with end-stage renal failure 181

Case 28 A 50-year-old man on peritoneal dialysis with abdominal pain 187

Renal Transplantation

Case 29 A 49-year-old man with chronic kidney disease 193

Case 30 A 38-year-old man with a rise in creatinine 2 weeks post renal transplant 201

Case 31 A 45-year-old man with a renal transplant and fever 210

Part 3 Self-assessment 215

MCQs 215

EMQs 220

SAQs 227

Answers 229

Index of cases by diagnosis 246

Index 247

About the Author

Dr Menna Clatworthy, Clinical Lecturer in Renal Medicine, University of Cambridge.

Reviews

"This is a helpful resource for medical students, medicine interns and residents, and nephrology fellows, as well as a reference for teachers of nephrology ... I would recommend this for academic nephrologists and nephrology fellows, but mainly for residents and students on nephrology rotations." (Doody's, 9 March 2012) "The presentation is lively and the author's experience and enthusiasm for teaching the subject over more than a decade is evident...This book should appeal not only to medical undergraduates but also to trainees in renal diseases and other related specialties." ( Journal of Tropical Pediatrics , January 2011)"The beauty of this book is that it translates a lot of the very dry information provided in traditional text books into real-life scenarios. The cases are interesting to read and you always like to see if your own management plan corresponds to the expert's one. In summary this is a very useful book for all who work in renal medicine. The clear format makes it suitable for nurses as well as doctors, and explains the rationale behind a lot of the treatment decisions we make. Overall highly recommended." ( Journal of Renal Nursing, may 2010)

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