Morning Rounds · Dialysis & Transplantation Renal Transplant Rejection — Types & Features Type Timing Mechanism Histology Treatment Hyperacute Minutes–hours on table Pre-formed anti-donor HLA antibodies (AMR) Thrombosis, necrosis fibrin thrombi Irreversible; graft removal Acute…
Morning Rounds · Electrolytes — The Renal Lens Hyponatraemia — Diagnostic Framework Serum Osmolality High (>290): Hyperglycaemia Normal (280–290): Pseudohyponatraemia (hyperlipidaemia, hyperproteinaemia) Low (<280): True hyponatraemia Assess volume status + urine Na Hypovolaemic U-Na <20:…
Morning Rounds · Renal Tubular Disorders Renal Tubular Acidosis — Comparison Feature Type I (Distal) Type II (Proximal) Type IV Normal AG acidosis Defect H⁺ secretion (collecting duct) HCO₃⁻ reabsorption (proximal tubule) Aldosterone deficiency /…
Morning Rounds · Glomerular Diseases Nephrotic vs Nephritic Syndrome Feature Nephrotic Nephritic Proteinuria >3.5 g/day (massive) <3.5 g/day (mild–mod) Haematuria Absent / minimal Prominent (RBC casts) Oedema Severe (hypoalbuminaemia) Mild–moderate (Na retention) BP / renal…
Morning Rounds · Chronic Kidney Disease CKD Staging — KDIGO 2012 (eGFR + Albuminuria) eGFR-based Stage Albuminuria Category (mg/g or mg/mmol) G1 Normal / High eGFR ≥ 90 G2 Mildly decreased 60 – 89 G3a…
Morning Rounds · Acute Kidney Injury AKI Classification Systems Stage Serum Creatinine Urine Output RIFLE: Risk KDIGO: Stage 1 ↑ ≥1.5× baseline OR ≥0.3 mg/dL (within 48 h) <0.5 mL/kg/h for >6 h RIFLE: Injury…