12.09.27 Renal revision
The bad one!
Has an O:
Proteinuria >3 g/day
Maybe also raised cholesterol
Exogenous albumin is little use
Only lasts 30 mins
Give high dose steroids
2 mg/kg prednisolone up to 60 mg max
Beware activation of chicken pox!
Takes 10 days to work, during which they'll get worse
Alternative drugs if multiple relapses:
DON'T give them diuretics!
Worsens the decreased circulating volume
Don't be confused by their oedema
Can maybe give in combination with albumin
Squeeze it hard to deflate
30-80% relapse rate
Especially if Asian
Completely different beast to nephrotic!
Not nearly so bad
Inflammation injures capillary walls, permitting escape of red cells into urine
Anti-strep titres (if post-strep)
Kidneys are not working at all:
Crucial to monitor fluid balance
Treatment of hyperkalaemia
Insulin + glucose