CAUSES OF POLYURIA
Excess fluid intakeOsmotic, e.g. Hyperglicaemia
Cranial diabetes insipidus (loss of antidiuretic hormone - AHD)
Nephrogenic diabetes insipidus (tubular dysfunction) Genetic tubular cell effects: AHD receptor, aquaporin mutations
Drugs/toxins: lithium, diuretics, hypercalcaemia Interstitial renal disease
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Some renal symptoms and their causes
Oliguria or anuria
Hypovolaemia (dehydration or shock)
Acute renal failure caused by acute glomerulonephritis
Bilateral ureteric obstruction (retroperitoneal fibrosis)
Detrusor muscle failure (bladder outlet obstruction or neurological disease)
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Some renal symptoms and their causes
Dysuria
Dysuria describes a stinging or burning sensation that occurs when passing urine. It is often accompanied by frequency and urgency. The most common cause of dysuria is cystitis
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Anamnesis
• Anamnesis morbi
-overcooling
-infection (streptococcus, viruses, HIV, syphilis, tuberculosis, leptospirosis, hemorrhagic fever, malaria)
-allergic reactions
- gestosis, miscarriage
-drugs (analgesic, gold containing preparations, D- penicillamin, aminoglycosides, antiepileptic drugs)
-alcohol/ narcotic abuse
Anamnesis
• Anamnesis vitae
-old and concomitant diseases: chronic tonsillatis, AH, DM, gout, liver pathology, tumors, chronic purulent diseases, tuberculosis, systemic diseases (SLE, reumatic arthritis, systemic vasculitis)
-profession: contact with radiation, benzol, solvents, hydrocarbons, heavy and rare metals, poisons
-family history (polycystic disease, Alport syndrome, Fanconi syndrome and other)
Physical examination
• Inspection (edema, color of skin, hemorrhages, “butterfly” symptom livedo reticularis, traces of scratches, disembriogenetic stigmas)
• Palpation
-kidneys (tumor, nephroptosis, cyst, policystic disease) -full urinary bladder
• Percussion
-striking test in loin region
paranephritis)
-full urinary bladder
•Auscultation (renal artery stenosis)
Facies nephritica (Acute GN)
Edema (Acute GN)
Edema (nephrotic syndrome)
