SlideShare une entreprise Scribd logo
1  sur  36
AN UNUSUAL CASE OF RENAL FAILURE Dr.P.ARUL. PG Prof. VIJAYARAGAVAN’s Unit
60 years old female patient Sabira admitted with complaints of  Burning micturition For 3 days Abdomen pain Fever
H/o Presenting illness : Fever – High grade, intermittent , associated with chills. Abdomen pain – Lower abdomen and also in the flanks. Burning micturition+  No C/o vomiting. No C/o oliguria. No C/o Facial puffiness or leg swelling.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DISCUSSION
DIABETES &KIDNEY RELATED COMPLICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Renal dysfunction in DM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Renal pathology in DM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
UAER ,[object Object],[object Object],[object Object],[object Object],>200 >300 Overt nephropathy 20-200 30-300 Microalbuminuria <20 <30 Normoalbuminuria overnight 24hrs(mg/day)
Renal papillary necrosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Analgesic induced RPN ,[object Object],[object Object],[object Object],[object Object]
Pathophysiology  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Normal kidney Hypoperfused kidney Does not depend upon  local Prostaglandins  for adequate perfusion Depend upon  local Prostaglandins  for adequate perfusion NO EFFRECT RENAL PAPILLARY NECROSIS ANALGESICS – COX1/COX2 INHIBITORS
Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Excretory urography in a patient with renal papillary necrosis  and pyeloureteritis cystica. There is bilateral loss of the renal mantle  with contrast tracking from the renal fornix in the lower pole of the right kidney.  There is also multiple smooth filling defects in the ureter, caused by ureteritis cystica
Photograph of a gross section from the right kidney  shows abscesses in the cortex (arrowheads)  and hemorrhagic infarcts in papillary regions (arrows),  findings indicative of pyonephrosis and necrotizing papillitis, respectively.
Treatment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other renal diseases in DM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Autonomic neuropathy of bladder ,[object Object],Functional incompetence of UV junction Recurrent UTI Urethral sphincter dysynergy Weakened bladder contraction & incomplete emptying. Increased residual volume Noctuira Decrease in daytime micturition frequency Disruption of parasympathetic innervation to detrusor & efferent sympathetic innervations to trigone Decreased awareness of bladder distension & then micturition at progressively larger volumes Asymptomatic  Destruction of proprioceptive afferent fibres Sign  Symptoms Pathology
Thank you
9 0 At diagnosis 15 15 Overt nephropathy 38 16 Microalbuminuria Type 2 DM Type 1 DM Prevalence
Investigation & treatment for microalbuminuria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Albuminuria in type 1 DM and development of complications 50 11 58 80 Macroalbuminuria  31 6 28 40 Microalbuminuria  21 1 12 20 Normoalbuminuria  Prevalence of neuropathy % Prevalence of blindness % Prevalence of retinopathy % Prevalence of  HT % UAER
Diabetic nephropathy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications for renal biopsy ,[object Object],[object Object],[object Object],[object Object]

Contenu connexe

Tendances

Renal system history taking & urine analysis 2012
Renal system history taking & urine analysis 2012Renal system history taking & urine analysis 2012
Renal system history taking & urine analysis 2012
Reina Ramesh
 

Tendances (20)

Evaluation of the patient with hematuria.
Evaluation of the patient with hematuria.Evaluation of the patient with hematuria.
Evaluation of the patient with hematuria.
 
UTI Case Presentation
UTI Case PresentationUTI Case Presentation
UTI Case Presentation
 
Renal system history taking & urine analysis 2012
Renal system history taking & urine analysis 2012Renal system history taking & urine analysis 2012
Renal system history taking & urine analysis 2012
 
Unusual presentation of psoas abscess _a case
Unusual presentation of psoas abscess  _a caseUnusual presentation of psoas abscess  _a case
Unusual presentation of psoas abscess _a case
 
Renovascular hypertension(rvh)
Renovascular hypertension(rvh)Renovascular hypertension(rvh)
Renovascular hypertension(rvh)
 
Benign Prostatic Hyperplasia (Surgical Case Presentation)
Benign Prostatic Hyperplasia (Surgical Case Presentation)Benign Prostatic Hyperplasia (Surgical Case Presentation)
Benign Prostatic Hyperplasia (Surgical Case Presentation)
 
Chyluria and its Mangagement
Chyluria and its MangagementChyluria and its Mangagement
Chyluria and its Mangagement
 
Case study on spleenomegaly with portal hypertension
Case study on spleenomegaly with portal hypertensionCase study on spleenomegaly with portal hypertension
Case study on spleenomegaly with portal hypertension
 
pediatric Acute Kidney Injury - AKI
pediatric Acute Kidney Injury - AKI pediatric Acute Kidney Injury - AKI
pediatric Acute Kidney Injury - AKI
 
Urodynamic study
Urodynamic studyUrodynamic study
Urodynamic study
 
Nephrotic Syndrome Case Presentation
Nephrotic Syndrome Case PresentationNephrotic Syndrome Case Presentation
Nephrotic Syndrome Case Presentation
 
Chronic pyelonephritis
Chronic pyelonephritisChronic pyelonephritis
Chronic pyelonephritis
 
Nephrotic syndrome and a case report
Nephrotic syndrome and a case reportNephrotic syndrome and a case report
Nephrotic syndrome and a case report
 
Approach to CKD
Approach to CKDApproach to CKD
Approach to CKD
 
Infection Related Glomerulopathy - Introduction – Rapid Overview - Dr. Gawad
Infection Related Glomerulopathy - Introduction – Rapid Overview - Dr. GawadInfection Related Glomerulopathy - Introduction – Rapid Overview - Dr. Gawad
Infection Related Glomerulopathy - Introduction – Rapid Overview - Dr. Gawad
 
steroid resistant nephrotic syndrome
steroid resistant nephrotic syndromesteroid resistant nephrotic syndrome
steroid resistant nephrotic syndrome
 
Approach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundiceApproach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundice
 
CASE PRESENTATION ON obstructive jaundice
CASE PRESENTATION ON  obstructive jaundice CASE PRESENTATION ON  obstructive jaundice
CASE PRESENTATION ON obstructive jaundice
 
CKD Mineral Bone Disorder (CKD-MBD) - Dr. Gawad
CKD Mineral Bone Disorder (CKD-MBD) - Dr. GawadCKD Mineral Bone Disorder (CKD-MBD) - Dr. Gawad
CKD Mineral Bone Disorder (CKD-MBD) - Dr. Gawad
 
Obstructive uropathy
Obstructive uropathyObstructive uropathy
Obstructive uropathy
 

En vedette

Case Study Presentation-Rachael Joseph
Case Study Presentation-Rachael JosephCase Study Presentation-Rachael Joseph
Case Study Presentation-Rachael Joseph
Rachael Joseph
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
raj kumar
 
Kidney Disease Case Study
Kidney Disease Case StudyKidney Disease Case Study
Kidney Disease Case Study
lusimartin
 
Special stains in histopathology
Special stains in histopathologySpecial stains in histopathology
Special stains in histopathology
Ekta Jajodia
 

En vedette (18)

MPGN case presentation
MPGN case presentationMPGN case presentation
MPGN case presentation
 
IMWG updates on plasma cell dyscrasias
IMWG updates on plasma cell dyscrasias IMWG updates on plasma cell dyscrasias
IMWG updates on plasma cell dyscrasias
 
Renovascular disorders
Renovascular disordersRenovascular disorders
Renovascular disorders
 
Case Study Presentation-Rachael Joseph
Case Study Presentation-Rachael JosephCase Study Presentation-Rachael Joseph
Case Study Presentation-Rachael Joseph
 
renal biopsy
renal biopsyrenal biopsy
renal biopsy
 
Special stains
Special stainsSpecial stains
Special stains
 
Pathology Of Kidney
Pathology Of KidneyPathology Of Kidney
Pathology Of Kidney
 
Introduction to Renal Pathology
Introduction to Renal PathologyIntroduction to Renal Pathology
Introduction to Renal Pathology
 
Renal Histology
Renal HistologyRenal Histology
Renal Histology
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
 
Renal Pathology Tutorial
Renal Pathology TutorialRenal Pathology Tutorial
Renal Pathology Tutorial
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
 
Kidney histology
Kidney histologyKidney histology
Kidney histology
 
Kidney Disease Case Study
Kidney Disease Case StudyKidney Disease Case Study
Kidney Disease Case Study
 
Case study: End stage renal failure
Case study: End stage renal failureCase study: End stage renal failure
Case study: End stage renal failure
 
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. GawadRenal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
Renal Histo-Pathology (I) - Normal Kidney Light Microscopy - Dr. Gawad
 
Special stains in histopathology
Special stains in histopathologySpecial stains in histopathology
Special stains in histopathology
 
Special stain in histopathology
Special stain in histopathologySpecial stain in histopathology
Special stain in histopathology
 

Similaire à An Unusual Case Of Renal Failure

Non Glomerular Disease
Non Glomerular DiseaseNon Glomerular Disease
Non Glomerular Disease
Patrick Carter
 
CHRONIC KIDENY DISEASE ......CKD ........DR ASEM MOH.ABOU ISSA.....NEPHROL...
CHRONIC KIDENY DISEASE  ......CKD ........DR   ASEM MOH.ABOU ISSA.....NEPHROL...CHRONIC KIDENY DISEASE  ......CKD ........DR   ASEM MOH.ABOU ISSA.....NEPHROL...
CHRONIC KIDENY DISEASE ......CKD ........DR ASEM MOH.ABOU ISSA.....NEPHROL...
Asem Mohamed
 
Major Nonglomerular Disorders
Major Nonglomerular DisordersMajor Nonglomerular Disorders
Major Nonglomerular Disorders
Tejas Desai
 
Approach to the Patient with Renal Disease
Approach to the Patient with Renal DiseaseApproach to the Patient with Renal Disease
Approach to the Patient with Renal Disease
Patrick Carter
 
Acute renal failure
Acute renal failureAcute renal failure
Acute renal failure
ess_online
 

Similaire à An Unusual Case Of Renal Failure (20)

Unusual cause of Renal failure
Unusual cause of Renal failureUnusual cause of Renal failure
Unusual cause of Renal failure
 
Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.Acute and Chronic Renal Failure. Easy Slides.
Acute and Chronic Renal Failure. Easy Slides.
 
Chronic Kidney Disease.pdf
Chronic Kidney Disease.pdfChronic Kidney Disease.pdf
Chronic Kidney Disease.pdf
 
anaesthesia in chronic kidney disease
anaesthesia in chronic kidney diseaseanaesthesia in chronic kidney disease
anaesthesia in chronic kidney disease
 
Adult polycystic kidney disease
Adult polycystic kidney disease Adult polycystic kidney disease
Adult polycystic kidney disease
 
Management of Chronic Kidney Disorder (CKD)
Management of Chronic Kidney Disorder (CKD)Management of Chronic Kidney Disorder (CKD)
Management of Chronic Kidney Disorder (CKD)
 
Non Glomerular Disease
Non Glomerular DiseaseNon Glomerular Disease
Non Glomerular Disease
 
GENITO-URINARY SYSTEM DISORDERS PART-1.
GENITO-URINARY SYSTEM DISORDERS PART-1.GENITO-URINARY SYSTEM DISORDERS PART-1.
GENITO-URINARY SYSTEM DISORDERS PART-1.
 
CKD(1).pptx
CKD(1).pptxCKD(1).pptx
CKD(1).pptx
 
Chronic kidney disease
Chronic kidney diseaseChronic kidney disease
Chronic kidney disease
 
Chronic renal Disease\failure (CKD)
Chronic renal Disease\failure (CKD)Chronic renal Disease\failure (CKD)
Chronic renal Disease\failure (CKD)
 
Glomerulonephritis (1)
Glomerulonephritis (1)Glomerulonephritis (1)
Glomerulonephritis (1)
 
CHRONIC KIDENY DISEASE ......CKD ........DR ASEM MOH.ABOU ISSA.....NEPHROL...
CHRONIC KIDENY DISEASE  ......CKD ........DR   ASEM MOH.ABOU ISSA.....NEPHROL...CHRONIC KIDENY DISEASE  ......CKD ........DR   ASEM MOH.ABOU ISSA.....NEPHROL...
CHRONIC KIDENY DISEASE ......CKD ........DR ASEM MOH.ABOU ISSA.....NEPHROL...
 
nephrotic syndrome final TREATMENT EVALUATION.ppt
nephrotic syndrome final TREATMENT EVALUATION.pptnephrotic syndrome final TREATMENT EVALUATION.ppt
nephrotic syndrome final TREATMENT EVALUATION.ppt
 
Major Nonglomerular Disorders
Major Nonglomerular DisordersMajor Nonglomerular Disorders
Major Nonglomerular Disorders
 
Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).Renal manifestations of systemic disease(s).
Renal manifestations of systemic disease(s).
 
Acute kidney injury and chronic kidney disease in children
Acute kidney injury and chronic kidney disease in childrenAcute kidney injury and chronic kidney disease in children
Acute kidney injury and chronic kidney disease in children
 
Approach to the Patient with Renal Disease
Approach to the Patient with Renal DiseaseApproach to the Patient with Renal Disease
Approach to the Patient with Renal Disease
 
Acute renal failure
Acute renal failureAcute renal failure
Acute renal failure
 
Cirrhosis complications
Cirrhosis complicationsCirrhosis complications
Cirrhosis complications
 

Plus de Stanley Medical College, Department of Medicine

Plus de Stanley Medical College, Department of Medicine (20)

Interpretation of Liver Function Tests
Interpretation of Liver Function TestsInterpretation of Liver Function Tests
Interpretation of Liver Function Tests
 
A Case of Sheehan's Syndrome
A Case of Sheehan's SyndromeA Case of Sheehan's Syndrome
A Case of Sheehan's Syndrome
 
Imaging: Cortical Vein Thrombosis
Imaging: Cortical Vein ThrombosisImaging: Cortical Vein Thrombosis
Imaging: Cortical Vein Thrombosis
 
ECG: Findings in CNS disorders
ECG: Findings in CNS disordersECG: Findings in CNS disorders
ECG: Findings in CNS disorders
 
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVDA Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
 
A Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISMA Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISM
 
IMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSISIMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSIS
 
ECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AFECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AF
 
Imaging: BOOP
Imaging: BOOPImaging: BOOP
Imaging: BOOP
 
ECG: Hypokalemia
ECG: HypokalemiaECG: Hypokalemia
ECG: Hypokalemia
 
A Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary HypertensionA Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary Hypertension
 
A Case of Schmidt Syndrome
A Case of Schmidt Syndrome A Case of Schmidt Syndrome
A Case of Schmidt Syndrome
 
A Case of Rodenticide Poisoning
A Case of Rodenticide PoisoningA Case of Rodenticide Poisoning
A Case of Rodenticide Poisoning
 
A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis
 
Imaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary LesionsImaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary Lesions
 
ECG: Atrial Dissociation
ECG: Atrial DissociationECG: Atrial Dissociation
ECG: Atrial Dissociation
 
A Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary SyndromeA Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary Syndrome
 
A Case of Thalassemia
A Case of ThalassemiaA Case of Thalassemia
A Case of Thalassemia
 
A Case of Renal Amyloidosis
A Case of Renal AmyloidosisA Case of Renal Amyloidosis
A Case of Renal Amyloidosis
 
CXR: Silico-Tuberculosis
CXR: Silico-TuberculosisCXR: Silico-Tuberculosis
CXR: Silico-Tuberculosis
 

Dernier

Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 

Dernier (20)

Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 

An Unusual Case Of Renal Failure

  • 1. AN UNUSUAL CASE OF RENAL FAILURE Dr.P.ARUL. PG Prof. VIJAYARAGAVAN’s Unit
  • 2. 60 years old female patient Sabira admitted with complaints of Burning micturition For 3 days Abdomen pain Fever
  • 3. H/o Presenting illness : Fever – High grade, intermittent , associated with chills. Abdomen pain – Lower abdomen and also in the flanks. Burning micturition+ No C/o vomiting. No C/o oliguria. No C/o Facial puffiness or leg swelling.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22. Normal kidney Hypoperfused kidney Does not depend upon local Prostaglandins for adequate perfusion Depend upon local Prostaglandins for adequate perfusion NO EFFRECT RENAL PAPILLARY NECROSIS ANALGESICS – COX1/COX2 INHIBITORS
  • 23.
  • 24.
  • 25. Excretory urography in a patient with renal papillary necrosis and pyeloureteritis cystica. There is bilateral loss of the renal mantle with contrast tracking from the renal fornix in the lower pole of the right kidney. There is also multiple smooth filling defects in the ureter, caused by ureteritis cystica
  • 26. Photograph of a gross section from the right kidney shows abscesses in the cortex (arrowheads) and hemorrhagic infarcts in papillary regions (arrows), findings indicative of pyonephrosis and necrotizing papillitis, respectively.
  • 27.
  • 28.
  • 29.
  • 30.
  • 32. 9 0 At diagnosis 15 15 Overt nephropathy 38 16 Microalbuminuria Type 2 DM Type 1 DM Prevalence
  • 33.
  • 34. Albuminuria in type 1 DM and development of complications 50 11 58 80 Macroalbuminuria 31 6 28 40 Microalbuminuria 21 1 12 20 Normoalbuminuria Prevalence of neuropathy % Prevalence of blindness % Prevalence of retinopathy % Prevalence of HT % UAER
  • 35.
  • 36.