💧 Renal syndromes are a group of disorders that impair the kidneys’ ability to regulate fluid balance, electrolyte homeostasis, and waste excretion. They may arise from vascular, inflammatory, autoimmune, metabolic, or genetic causes. Early recognition and appropriate management can prevent irreversible renal damage and improve outcomes. 🩺🧠

🧠 Summary Table of Major Renal Syndromes

🩸 Syndrome	⚙️ Definition & Mechanism	🧪 Key Diagnostic Features	💊 Management
🚨 Acute Kidney Injury (AKI)	Sudden decline in kidney function → accumulation of urea, creatinine, and fluid. 🧩 Classified as: • Pre-renal: ↓ renal perfusion (shock, dehydration) • Intrinsic: tubular/glomerular injury (toxins, ischaemia) • Post-renal: obstruction (stones, prostate, tumour)	• ↑ Serum creatinine, ↓ urine output • Urea:Creatinine ratio helps differentiate pre-renal vs intrinsic • Ultrasound: obstruction or structural cause	• Restore perfusion (fluids, treat shock) • Remove toxins / stop nephrotoxic drugs • Relieve obstruction if post-renal • Dialysis if refractory or severe 🩸
⏳ Chronic Kidney Disease (CKD)	Progressive & irreversible decline in kidney function over months–years. Often due to diabetes, hypertension, or glomerulonephritis. Leads to uraemia, anaemia, and bone–mineral disorders.	• eGFR < 60 mL/min for ≥3 months • Proteinuria or abnormal urine sediment • US: small shrunken kidneys (except diabetic nephropathy)	• Control BP (ACEi/ARB) 💊 • Manage diabetes • Restrict salt/protein intake • Treat anaemia & CKD-MBD • Dialysis or transplant if eGFR < 15 mL/min
💦 Nephrotic Syndrome	Massive protein loss in urine due to glomerular barrier defect → ↓ plasma oncotic pressure → oedema & hyperlipidaemia. Common causes: Minimal change disease, FSGS, diabetes, lupus.	• Proteinuria > 3.5 g/day • Hypoalbuminaemia, oedema, hyperlipidaemia • Fatty casts (“Maltese crosses”) on microscopy	• Salt restriction, diuretics for oedema 💧 • Corticosteroids ± immunosuppressants • Statins for dyslipidaemia • Treat underlying disease
🩸 Nephritic Syndrome	Glomerular inflammation → ↓ GFR, RBC leakage → haematuria & hypertension. Common causes: Post-streptococcal GN, IgA nephropathy, lupus nephritis.	• Haematuria (RBC casts) 🔬 • Proteinuria (usually < 3 g/day) • Oliguria, ↑ creatinine, hypertension • Complement levels may be low (C3↓)	• Treat infection or autoimmune trigger • Corticosteroids / immunosuppressants • Control BP (ACEi/ARB) • Dialysis in severe renal failure
🧬 Polycystic Kidney Disease (PKD)	Genetic disorder (ADPKD or ARPKD) → progressive cyst formation, kidney enlargement, and renal failure. Associated with hepatic cysts & berry aneurysms. 🧠	• Family history of PKD • Imaging (US/CT/MRI): multiple bilateral cysts • Genetic testing (PKD1, PKD2)	• BP control (ACEi/ARB) 💊 • Pain management • Treat infection or stones • Tolvaptan (vasopressin antagonist) slows progression • Dialysis or transplant in ESRD

🧭 Key Teaching Points

💡 AKI = sudden & potentially reversible; CKD = gradual & irreversible.
💦 Nephrotic → heavy protein loss + oedema; Nephritic → blood + hypertension.
🧬 PKD → genetic, cystic enlargement of kidneys; monitor family members.
🧠 Always assess for reversible factors: dehydration, infection, obstruction, or medication toxicity.
🫀 Control blood pressure — the single most important measure to slow renal decline.

💡 Teaching Tip: Think of renal syndromes as points along a spectrum — from acute injury (AKI) to chronic failure (CKD), and from protein leak (nephrotic) to blood leak (nephritic). Recognising patterns early can prevent dialysis dependence and preserve kidney life. 💙🩺🧬

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Renal syndromes

🧠 Summary Table of Major Renal Syndromes

🧭 Key Teaching Points

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