痛風腎の検査所見腹部超音波検査で腎髄質部に尿酸塩沈着（皮質よりも高いレベルで描出）がみられる．また腎病理像では尿酸塩結晶による尿細管間質性腎炎がみられる renal国試 Feb 3, 2021, 11:47 PM HirotoShishido
Management of chronic kidney disease• diet
■ preventing HTN and volume overload
■ ☆low-protein diet
• Na+ restriction
■ preventing electrolyte imbalances
■ target of <2 g/d (5 g/d of salt)
• K+ restriction (40-60 mmol/d)
• PO43– restriction (1 g/d)
• avoid extra-dietary Mg2+ (e.g. antacids)
■ preventing uremia and potentially delaying decline in GFR
• protein restriction with adequate caloric intake (☆25-35kcal/kg day) in order to limit endogenous protein catabolism renal国試過去3年 Oct 18, 2020, 2:16 AM HirotoShishido
definition of chronic kidney disease①尿異常，画像診断，血液，病理で腎障害の存在が明らか．特に蛋白尿の存在が重要．
②糸球体濾過量（GFR：glomerular filtration rate）＜60mL/分/1.73m2
①，②のいずれか，または両方が3ヵ月以上持続する．
→ GFRが正常でも，☆血尿・尿潜血が3ヵ月以上続けばCKDと定義される．
GFRが正常でも☆顕性蛋白尿(>=0.5g/日) が3ヵ月続けばCKDである． renal国試過去3回国試直前 Oct 12, 2020, 2:22 AM HirotoShishido
management of nocturnal enuresisEnuresis alarms are the most effective long-term intervention but can take 3-4 months to be effective.
Pharmacotherapy with ★desmopressin is also considered first-line therapy for those who desire immediate improvement. pediatricsrenalUWorld step2CK Sep 20, 2020, 5:26 AM HirotoShishido
causes of hypokalemia・decreased intake
・intracellular translocation
insulin, β-adrenargic activity(dobutamine, ☆stress-induced(eg. alcohol withdrawal, acute MI)), alkalosis
・GI loss
diarrhea, vomiting, hyperaldosteroeism
・urinary loss
hyperaldosteroeism, diuretics, RTA (type Ⅰ, Ⅱ)
・sweat loss renalendocrinologyUWorld Jul 9, 2020, 2:16 AM HirotoShishido
diagnosis/ causes of rhabdomyolysis☆Positive blood on urine dipstick (a reaction that detects the heme pigment in both hemoglobin and myoglobin) in the absence of red blood cells on microscopic urinalysis suggests myoglobinuria.
