How kidney patients are presented

Abnormal laboratory studies (e.g., elevated blood urea nitrogen [BUN] and serum
creatinine, decreased estimated glomerular filtration rate, or abnormal serum electrolyte
values)
n Asymptomatic urinary abnormalities (e.g., gross or microscopic hematuria, proteinuria,
microalbuminuria)
n Changes in urinary frequency or problems with urination (e.g., polyuria, nocturia, urgency)
n New-onset hypertension
n Worsening edema in dependent areas
n Nonspecific symptomatologies (e.g., nausea, vomiting, malaise)
n At times symptoms can be specific (e.g., ipsilateral flank pain in those with obstructing
nephrolithiasis)
n Incidental discovery of anatomic renal abnormalities on routine imaging studies
(e.g., horseshoe kidney, congenitally absent or ptotic kidney, asymmetric kidneys,
angiomyolipoma, renal mass, polycystic kidneys)

Case Review Stone in Young Age

18 year male with history of recurrent calcium oxalate stone presented with

Nausea, vomiting and pruritis.

On examination : He had pale conjuctiva, trace limb edema and normal prssures.

Lab shows:

Urea 70 mg/dl.  S . Creatinine 5.1 mg/dl.

Hco3 18 ;  Ca 8.2;  Po4 7.0;

Ultrasound shows normal size kidney with multiple concretions bilatteally and

No obstruction seen.

24 hours urinary protein excretion 350mg.

Q: what is the aetiology of renal failure and what is the treatment?

Answere: 

The likely diagnosis is Hyperoxalurea.

High urine out put should be maintained. Avoid oxalate rich foods.

Some patients with primary hyperoxalurea respond to high dose pyridoxine.

Oral citrated may be of benefit. Once renal failure develops , patients with Primary hyperoxalurea

Should be advised of liver and kidney both transplantaion.