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RENAL MEDICINE

Renal disease: Acute pyelonephritis can have serious complications

15 Apr 2010Registered users

The incidence of acute pyelonephritis is higher in young women than in men but the incidence in men over 65 years of age is similar to that in older women. Women have up to a 10% risk of recurrent acute pyelonephritis in the year following a first acute episode, the equivalent risk in men is lower at 6%. Acute pyelonephritis may be uncomplicated and resolve without serious sequelae. However, a minority of episodes may be complicated by acute kidney injury, papillary necrosis, renal or perinephric abscess or the development of emphysematous pyelonephritis.

 

Renal disease: GPs should be vigilant for glomerulonephritis

14 Apr 2010

Across all age groups, glomerulonephritis is the second most common renal disease leading to end-stage renal disease in the UK, but is relatively more common in those requiring renal replacement therapy under the age of 65. The incidence of glomerulonephritis is reported as 73 cases per million population per year. This equates to one new presentation per GP practice in the UK approximately every other year. With an average 10-year survival of 63%, most practices are likely to have a small number of patients with chronic glomerulonephritis at any one time.
 

Early detection of CKD will reduce heart disease risk

25 Apr 2009Paid-up subscribers

In April 2008, the Department of Health announced a strategy to reduce the adverse effects of vascular disease by focusing on its earlier detection.1 By introducing 'vascular checks' targeting those aged between 40 and 75 years of age, it is estimated that at least 25,000 people a year with diabetes or kidney disease will be diagnosed earlier. With increasing evidence that early treatment of kidney disease can slow, if not prevent, progression to established renal failure, early detection is of clear benefit from a purely renal perspective.

 

Evaluating haematuria in primary care

25 Apr 2009Registered users

Haematuria is a fairly common problem in general practice with a higher incidence in patients over 40 years old. In adults the reported prevalence of microscopic haematuria varies considerably, ranging from 1 to 20% and is highest in men over 60 years old.3 In younger adults haematuria, particularly if it is transient, may have no obvious underlying cause. In contrast, persistent haematuria may herald the first presentation of serious urological or renal disease and there is an increased risk of malignancy in older patients. Nevertheless, in many patients no diagnosis for haematuria is established despite extensive investigation.

 

February 2008: Blood pressure control key in polycystic kidney disease

01 Feb 2008Paid-up subscribers

How can polycystic kidney disease present clinically? What are the criteria for diagnosing PKD? How should GPs manage patients with PKD?
 

February 2008: Identifying and managing nephrotic syndrome in adults

01 Feb 2008Paid-up subscribers

What are the main features of nephrotic syndrome? How can proteinuria be treated? How can complications be avoided?
 

February 2007: Early recognition the key to CKD

01 Feb 2007Paid-up subscribers

What is the relationship of CVD to CKD? How should you manage dipstick positive proteinuria or haematuria? Which patients need referral and when?
 

February 2007: Renal stone recurrence can be prevented

01 Feb 2007Paid-up subscribers

What are the common causes of renal stones? How should renal stones be investigated? How can recurrence be prevented?