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Classification and Prognosis of Chronic Kidney Disease

CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) for 3 months or more, irrespective of cause. Kidney damage in many kidney diseases can be ascertained by the presence of albuminuria, defined as albumin-to-creatinine ratio >30 mg/g in two of three spot urine specimens. Continue reading “Classification and Prognosis of Chronic Kidney Disease”

Diagnostic Criteria of Acute Rejection in Kidney Transplants

The gold standard for diagnosing acute rejection in kidney transplant recipients is tissue biopsy. Indications to pursue graft biopsy over concern for acute rejection include either an acute, otherwise unexplained deterioration in graft function or the presence of a biomarker consistent with acute rejection. Continue reading “Diagnostic Criteria of Acute Rejection in Kidney Transplants”

Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)

IgG4-related disease is characterized by a high level of serum IgG4 and dense infiltration of IgG4-positive plasma cells into multiple organs, with the kidney being one representative target. Although several sets of diagnostic criteria for autoimmune pancreatitis (AIP) are available and renal lesion is recognized as an extrapancreatic manifestation of AIP, it is difficult to differentiate IgG4-related tubulointerstitial nephritis (TIN) without
AIP from other types of TIN. Continue reading “Diagnostic Criteria for IgG4-Related Kidney Disease (IgG4-RKD)”

New Diagnostic Criteria Proposed for Polycystic Kidney Disease

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of kidney disease. Enlarging cysts within the kidneys are the clinical hallmark of the disease. Renal manifestations include varying degrees of kidney injury, urinary tract infections, kidney stones, and hematuria. Extrarenal manifestations can include pain, hypertension, left ventricular hypertrophy, hepatic cysts, intracranial aneurysm, diverticulosis, and abdominal and inguinal hernias. Continue reading “New Diagnostic Criteria Proposed for Polycystic Kidney Disease”

Revised Banff 2017 Classification of Antibody-Mediated Rejection (ABMR) in Renal Allografts

The Banff classification represented the first attempt to formulate an international, consensus based and structured classification system for the diagnosis and categorization of renal allograft biopsy pathology with a particular focus on the development of the morphological criteria for the diagnosis and classification of rejection. Continue reading “Revised Banff 2017 Classification of Antibody-Mediated Rejection (ABMR) in Renal Allografts”

Classifications of Acute Kidney Injury and Chronic Kidney Disease

Recently developed consensus functional definitions on the basis of specific changes in the serum creatinine concentration and urine volume now complement anatomical approaches to diagnosis.
Continue reading “Classifications of Acute Kidney Injury and Chronic Kidney Disease”

Definition and Classification/Staging System for Acute Kidney Injury (AKI)

In 2004, the ADQI group and representatives from three nephrology societies established the Acute Kidney Injury Network (AKIN). Its intentions are to facilitate international, interdisciplinary and intersocietal collaborations and to ensure progress in the field of AKI, including the development of uniform standards for the definition and classification of AKI. As part of this process, the RIFLE nomenclature and classification was modified to a staging/classification system differentiating between AKI stage I, II and III. In addition, a 48-hour time window for the diagnosis of AKI was introduced to ensure that the process was acute.
Continue reading “Definition and Classification/Staging System for Acute Kidney Injury (AKI)”

Indications of Dialysis in Renal Failure

Indications of dialysis in acute renal failure (ARF)

  • Severe fluid overload
  • Refractory hypertension
  • Uncontrollable hyperkalemia
  • Nausea, vomiting, poor appetite, gastritis with hemorrhage
  • Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures,
  • Pericarditis (risk of hemorrhage or tamponade)
  • bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding, etc.)
  • Severe metabolic acidosis
  • Blood urea nitrogen (BUN) > 70 – 100 mg/dl Continue reading “Indications of Dialysis in Renal Failure”
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