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## Mometrix ### Edema later in - Dyspnea, lung crackles - Gallop heart rhythm **Diagnosis** includes multiple serum and urine lab tests to determine cause and extent: - Acidic urine - Sp. Gravity low - Proteinuria - Increased BUN and creatinine - Electrolytes - hyperkalemia, hyperphosphatemia, an...

## Mometrix ### Edema later in - Dyspnea, lung crackles - Gallop heart rhythm **Diagnosis** includes multiple serum and urine lab tests to determine cause and extent: - Acidic urine - Sp. Gravity low - Proteinuria - Increased BUN and creatinine - Electrolytes - hyperkalemia, hyperphosphatemia, and hypocalcemia - Sodium levels vary - Increased potassium, calcium - Renal ultrasound - Renal biopsy **Treatment** includes: - Diuretics - Dialysis if necessary - Antibiotics with infection - Hyperkalemia: Kayexalate, albuterol - Acidosis: Sodium bicarbonate/citrate - Hypocalcemia: Calcium gluconate - 10% Hypertension: Sodium nitroprusside, nitroglycerine ### Renal Ultrasound Renal ultrasound is a non-invasive method of viewing the urinary structures. Ultrasound uses ultrasonic sound waves transmitted by a transducer, which picks up reflected sound waves that a computer converts to electronic images. Ultrasound can show fluid accumulation, the movement of blood through the kidney, masses, malformations (congenital abnormalities), change in size of the kidney or other structures, and obstructions, such as renal calculi. Ultrasound is usually done before a renal biopsy, and maybe done with a needle biopsy to guide placement of the needle. Patient preparation includes drinking two 8-ounce glasses of water one hour before the examination to ensure that the bladder is full. The patient should be reminded not to urinate before the ultrasound. The patient usually remains in supine position throughout the procedure but may be asked to turn to the side. No special precautions are necessary post-procedure. ### Renal Biopsy Renal biopsy to remove a small segment of cortical tissue helps to identify the extent of kidney disease with acute renal failure, transplant rejection, glomerulopathy, and persistent hematuria or proteinuria. Preoperative coagulation studies determine risk of bleeding. Biopsy is done percutaneously per needle biopsy (guided by fluoroscopy or ultrasound) or surgically through a small flank incision. A urine specimen must be obtained so it can be compared with a post-procedure specimen.