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Table of Contents Clinical Evaluation of Kidney Function Blood Pressure Measurement .................0005 27 Assessment of Kidney Function .................044 1 Proper Technique: 2.5 5 ors a tate: Rem eas EE A Pee 27 Biochemical Markers of Kidney Function ....... 31 Auscultatory Blood Pressure Monitoring ........ 28 Estimation of Glomerular Filtration Rate......... 1 Automated Blood Pressure Monitoring.......... 28 Interpretation of the Urinalysis..................... 3 Out-of-Office Blood Pressure Monitoring ....... 28 Urine DIPSUCK: «sas aiezmesgie sex we sere saws weaws 3 DeHiNitiONS ss ..2c cea meas Seaaiend 5 Ges 5 SF EEE G, SSR RS oe 29 Urine MicrOSCOpy <s2:ass5% ere ese eeeeesieieas 5 Screening and Diagnosis ............. 0. cece ee eee 29 Measurement of Albumin and Protein Excretion... 8 Evaluation of the Patient with Newly Clinical Evaluation of Hematuria................ 9 Diagnosed Hypertension ..............0000 cece eee 30 Imaging Studies..................0 0.0 e eee eee 10 History .. 0... ee ee eee ee eee ee 30

Interpretation of the Urinalysis..................... 3 Out-of-Office Blood Pressure Monitoring ....... 28 Urine DIPSUCK: «sas aiezmesgie sex we sere saws weaws 3 DeHiNitiONS ss ..2c cea meas Seaaiend 5 Ges 5 SF EEE G, SSR RS oe 29 Urine MicrOSCOpy <s2:ass5% ere ese eeeeesieieas 5 Screening and Diagnosis ............. 0. cece ee eee 29 Measurement of Albumin and Protein Excretion... 8 Evaluation of the Patient with Newly Clinical Evaluation of Hematuria................ 9 Diagnosed Hypertension ..............0000 cece eee 30 Imaging Studies..................0 0.0 e eee eee 10 History .. 0... ee ee eee ee eee ee 30 Kidney Biopsy sm: assassasmea ws sas pease nes Ree wT Re i Physical Examination ................ 000 eeeee 30 Testing ... 2... eee eee 31 Fluids and Electrolytes Primary HY PertenSion: oc.0¢ os a.3 ses & oS & FREE Gan FE 32 Osmolality and TOnicity w<< n:s0seusweseewermes cies i Pathogenesis: «ssc555 82 h5 4853 ee oes eee em: 32 Disorders of Serum Sodium...................000. i Management: « sce sa: c2ey 5.03 ws 5 fous 88:8 Te Bono a 32 Hyponatremia ......... eee eee ee eee eee i White Coat Hypertension................... cece 35 Hypernatremia 2asscscisseiasswetasaceeesaaan 13 Masked Hypertension. ............ 0.0 e cece eee eee 35 Disorders of Serum Potassium .................04. 14 Resistant Hypertension ............... 00 cece eee 36 Hypokalemia ............ 0.0. c cee eee eee 14 Secondary Hypertension ......................00. 36 Hyperkalemia .......... 0. cece cece eee 16 Kidney Disease ........... 0.00. e eee eee eee 36 Disorders of Serum Phosphate .................... 17 Renovascular Hypertension................... 37 Hypophosphatémia..« << 2.0: 2ssecsesweewcswens 17 Primary Hyperaldosteronism ................. 38 Hyperphosphatemia..................00.0005 18 Pheochromocytomas ..............0..eeeeeee 38 Disorders of Serum Magnesium .................-. 18 Hypertensive Urgency: < «iss aus deems aaiwer ai anewe 38 HYPOMIGHeSCHI + vcs me esereai meses eeemese Eee 18 Hypertensive EMEnenGy’ :sass22m0s me mesa saaea eras 39 HyPenMaPnesemla. ....a:casccaciwvewsw dew esm eae 19 Specie POpwulauions «<2 sesqsweemebaineimiew Rae 40

Kidney Biopsy sm: assassasmea ws sas pease nes Ree wT Re i Physical Examination ................ 000 eeeee 30 Testing ... 2... eee eee 31 Fluids and Electrolytes Primary HY PertenSion: oc.0¢ os a.3 ses & oS & FREE Gan FE 32 Osmolality and TOnicity w<< n:s0seusweseewermes cies i Pathogenesis: «ssc555 82 h5 4853 ee oes eee em: 32 Disorders of Serum Sodium...................000. i Management: « sce sa: c2ey 5.03 ws 5 fous 88:8 Te Bono a 32 Hyponatremia ......... eee eee ee eee eee i White Coat Hypertension................... cece 35 Hypernatremia 2asscscisseiasswetasaceeesaaan 13 Masked Hypertension. ............ 0.0 e cece eee eee 35 Disorders of Serum Potassium .................04. 14 Resistant Hypertension ............... 00 cece eee 36 Hypokalemia ............ 0.0. c cee eee eee 14 Secondary Hypertension ......................00. 36 Hyperkalemia .......... 0. cece cece eee 16 Kidney Disease ........... 0.00. e eee eee eee 36 Disorders of Serum Phosphate .................... 17 Renovascular Hypertension................... 37 Hypophosphatémia..« << 2.0: 2ssecsesweewcswens 17 Primary Hyperaldosteronism ................. 38 Hyperphosphatemia..................00.0005 18 Pheochromocytomas ..............0..eeeeeee 38 Disorders of Serum Magnesium .................-. 18 Hypertensive Urgency: < «iss aus deems aaiwer ai anewe 38 HYPOMIGHeSCHI + vcs me esereai meses eeemese Eee 18 Hypertensive EMEnenGy’ :sass22m0s me mesa saaea eras 39 HyPenMaPnesemla. ....a:casccaciwvewsw dew esm eae 19 Specie POpwulauions «<2 sesqsweemebaineimiew Rae 40 Acid-Base Disorders WOMEN << osscceeswcsmeeaiweswiges wise meas 40

Kidney Biopsy sm: assassasmea ws sas pease nes Ree wT Re i Physical Examination ................ 000 eeeee 30 Testing ... 2... eee eee 31 Fluids and Electrolytes Primary HY PertenSion: oc.0¢ os a.3 ses & oS & FREE Gan FE 32 Osmolality and TOnicity w<< n:s0seusweseewermes cies i Pathogenesis: «ssc555 82 h5 4853 ee oes eee em: 32 Disorders of Serum Sodium...................000. i Management: « sce sa: c2ey 5.03 ws 5 fous 88:8 Te Bono a 32 Hyponatremia ......... eee eee ee eee eee i White Coat Hypertension................... cece 35 Hypernatremia 2asscscisseiasswetasaceeesaaan 13 Masked Hypertension. ............ 0.0 e cece eee eee 35 Disorders of Serum Potassium .................04. 14 Resistant Hypertension ............... 00 cece eee 36 Hypokalemia ............ 0.0. c cee eee eee 14 Secondary Hypertension ......................00. 36 Hyperkalemia .......... 0. cece cece eee 16 Kidney Disease ........... 0.00. e eee eee eee 36 Disorders of Serum Phosphate .................... 17 Renovascular Hypertension................... 37 Hypophosphatémia..« << 2.0: 2ssecsesweewcswens 17 Primary Hyperaldosteronism ................. 38 Hyperphosphatemia..................00.0005 18 Pheochromocytomas ..............0..eeeeeee 38 Disorders of Serum Magnesium .................-. 18 Hypertensive Urgency: < «iss aus deems aaiwer ai anewe 38 HYPOMIGHeSCHI + vcs me esereai meses eeemese Eee 18 Hypertensive EMEnenGy’ :sass22m0s me mesa saaea eras 39 HyPenMaPnesemla. ....a:casccaciwvewsw dew esm eae 19 Specie POpwulauions «<2 sesqsweemebaineimiew Rae 40 Acid-Base Disorders WOMEN << osscceeswcsmeeaiweswiges wise meas 40 VEE VICI? ox ses cas 5 su: SREY Gad Tae E27 RT 19 Patients with Diabetes Mellitus................ 40

Acid-Base Disorders WOMEN << osscceeswcsmeeaiweswiges wise meas 40 VEE VICI? ox ses cas 5 su: SREY Gad Tae E27 RT 19 Patients with Diabetes Mellitus................ 40 Metabolic Acidosis .......... 0000. cc cece eee 20 Black Patients: . «ss cswsweaaseeineigixes © came 40 Gétieral APPrOaCh ; « ssass2ieeraesmscesmeamime 20 OldGP PAHENS «ges eise dedi wae i Bese eaw emis ws Al Increased Anion Gap Metabolic Acidosis ........ 21 Normal Anion Gap Metabolic Acidosis.......... 23 Chronic Tubulointerstitial Nephritis Metabolic Alkalosis « ose ssasaasnsseeseswcaniaases 24 Epidemiology and Pathophysiology ................ Al RESpiTalOry ACIOSIS es «a +x ee tang meee ew eamtews Re 26 Diagnosis and Evaluation. .......... 0.0.00. c eee eee 41 Respiratory Alkalosis ...............000 ee eee eee 26 CURSES wre «eens m ssn © arg be eR EYES WES EES EEE 43 Immunologic Diseases .......... 0.0.0 43 Hypertension Infectoms:s <3: 5as sea eed eaeed ewes wed msde 43 Epidemiology. .............-.. eee e cece eee ees 26 MAlSiSICY: so :aeserememer mene rere gtememoeste 43 Consequences of Sustained Hypertension........... 27 ME@UICAHONS <.e7dece wi earn tm, IVER Feeds te Fe gerne ea 43 Bnd-Orean [njury is ssa sa2eeesme esa seesads we 27 Drugs of Abuse .......... 0... c cece eee eee 44 Clinical Impact ..............0 0.00 cece e eee 27 Lead sx cimssmimzseesmes ers epe sees esas eases 44

Chronic Interstitial Nephritis in Acute Kidney Injury Agricultural Communities .................00. DGTIION s ws sarzm ns ae tm 5 Rees © 854 Soda wine aie RES ne 60 Aristolochic Acid Nephropathy ................ Epidemiology and Pathophysiology ................ 60 QODSERUCHON ais asa mise sue she tH st Paw tase Clinical Manifestations...............000000000 eee 62 ManageMelit .01.0ine wermesms wei rucsws wsimiaeaws DIA SHOS itis, snese.s t9 oh owl om bees dcoa was i ose beds 62 CaUSeS. cece eet es 63 Glomerular Diseases Prerenal Acute Kidney Injury ................. 63 Epidemiology and Pathophysiology ................ Intrinsic Kidney Diseases................000.. 63 Clinical Manifestations of Glomerular Disease ....... Postrenal Disease. ......... 0.0. e eee eee . 67 The Nephrotic Syndrome.................0005 SPEcilie Clinical SetHNGS «sa vaccs wi edac wie Pucw ns me BOWS 67 The Nephritic Syndrome ..................... Contrast-Associated Nephropathy.............. 67 Conditions Associated with the Cardiorenal Syndrome .................000005 68 Nephrotic Syndrome. ....... cece .... eeeeeeeeeee Hepatorenal Syndrome..............0 cece eee 68 Diabetic Kidney Disease....................4. Tumor Lysis Syndrome..................00005 68 Focal Segmental Glomerulosclerosis............ Abdominal Compartment Syndrome........... 68 Membranous Nephropathy ................... MaENASEINGHE , acs feel ade W id's Bed PSE bbs eene ees 69 Minimal Change Glomerulopathy.............. General Considerations..............00....0.. 69 Conditions Associated with the Renal Replacement Therapy................... 69 Nephritic Syndrome ........... 0000 cc eee ..... eee Rapidly Progressive Glomerulonephritis ........ Kidney Stones Anti-Glomerular Basement Membrane Antibody Disease. ......... 00. cece eee ... ee OVETVIEW 01e cette eee . ees 70 ANCA-Associated Glomerulonephritis.......... Clinical Manifestations............00 ccc cece eee . 70 Immune Complex—Mediated Did @NOSIS 5x ism es 82 Heap acn meee mur aeewemeswunn 70

Chronic Interstitial Nephritis in Acute Kidney Injury Agricultural Communities .................00. DGTIION s ws sarzm ns ae tm 5 Rees © 854 Soda wine aie RES ne 60 Aristolochic Acid Nephropathy ................ Epidemiology and Pathophysiology ................ 60 QODSERUCHON ais asa mise sue she tH st Paw tase Clinical Manifestations...............000000000 eee 62 ManageMelit .01.0ine wermesms wei rucsws wsimiaeaws DIA SHOS itis, snese.s t9 oh owl om bees dcoa was i ose beds 62 CaUSeS. cece eet es 63 Glomerular Diseases Prerenal Acute Kidney Injury ................. 63 Epidemiology and Pathophysiology ................ Intrinsic Kidney Diseases................000.. 63 Clinical Manifestations of Glomerular Disease ....... Postrenal Disease. ......... 0.0. e eee eee . 67 The Nephrotic Syndrome.................0005 SPEcilie Clinical SetHNGS «sa vaccs wi edac wie Pucw ns me BOWS 67 The Nephritic Syndrome ..................... Contrast-Associated Nephropathy.............. 67 Conditions Associated with the Cardiorenal Syndrome .................000005 68 Nephrotic Syndrome. ....... cece .... eeeeeeeeeee Hepatorenal Syndrome..............0 cece eee 68 Diabetic Kidney Disease....................4. Tumor Lysis Syndrome..................00005 68 Focal Segmental Glomerulosclerosis............ Abdominal Compartment Syndrome........... 68 Membranous Nephropathy ................... MaENASEINGHE , acs feel ade W id's Bed PSE bbs eene ees 69 Minimal Change Glomerulopathy.............. General Considerations..............00....0.. 69 Conditions Associated with the Renal Replacement Therapy................... 69 Nephritic Syndrome ........... 0000 cc eee ..... eee Rapidly Progressive Glomerulonephritis ........ Kidney Stones Anti-Glomerular Basement Membrane Antibody Disease. ......... 00. cece eee ... ee OVETVIEW 01e cette eee . ees 70 ANCA-Associated Glomerulonephritis.......... Clinical Manifestations............00 ccc cece eee . 70 Immune Complex—Mediated Did @NOSIS 5x ism es 82 Heap acn meee mur aeewemeswunn 70 Glomerulonephritis ....................0000. LYPES OL MONEY StOTESs 25 «ness a 2 5ca4 Set ous bs wes Fmd 70 Collagen Type IV-Related Nephropathies........ (CAlQUOM! seeder 2 w sae wm Ieee Bs ida sath hoo 71 Struvite... e e eee eee ees 71 Kidney Manifestations of Deposition Diseases UPCACG is sc asses moe oe bow omens eb wi bas Bm se 71

Glomerulonephritis ....................0000. LYPES OL MONEY StOTESs 25 «ness a 2 5ca4 Set ous bs wes Fmd 70 Collagen Type IV-Related Nephropathies........ (CAlQUOM! seeder 2 w sae wm Ieee Bs ida sath hoo 71 Struvite... e e eee eee ees 71 Kidney Manifestations of Deposition Diseases UPCACG is sc asses moe oe bow omens eb wi bas Bm se 71 OVELVieW «0 .6 e cece eee eee CySUNG ad; ass: osemE EST © tia bee are, 71 Monoclonal Immunoglobulin-Associated Management ........ 0... cece cece eee eee eens 71 Kidney Disease ...... 00.00 c cece ee ..... cece eeee Myeloma Cast Nephropathy...................00.. The Kidney in Pregnancy Monoclonal Gammopathy of Renal Significance... ... Normal Physiologic Changes in Pregnancy .......... 72 Monoclonal Immunoglobulin Deposition Disease ... . Hypertension in Pregnancy....................00, 72. Amyloidosis 0000s cece eee e .......... eee eee eees .. Chronic Hypertension ....................... he Cryoglobulinem 00000. c ia.......... cece eee aee .. Gestational Hypertension..................00. 73 Fibrillary and Immunotactoid Glomerulopathy ...... Acute-Onset Severe Hypertension ............. 73 PREECLAMPSIA 25.225: sw & suas use oe ook RSE RRA wy 73 Genetic Disorders and Kidney Disease Chronic Kidney Disease in Pregnancy .............. 74 Genetic Cystic Kidney Disorders................... Autosomal Dominant Polycystic Kidney Disease. . . Chronic Kidney Disease Tuberous Sclerosis Complex .................. Definition and Staging ..................00..00008 75 Genetic Noncystic Kidney Disorders................ Epidemiology and Pathophysiology ................ 75 Autosomal Dominant Tubulointerstitial SCRCCHING jon og ns res BER ERAT RES I LMTE B15 dead TAs beds 76 Kidney DISGASC! « sexe aessapa-e ta amet 2290 F dode Wee bu ® Clinical Manifestations............0...c cece ceeues 76 Collagen Type IV-Related Nephropathies........ DiaQnOSis sass vs aie se 8 ose ece ec ecee ems wie vme ew smeans 76 Fabry Disease..... 00.000 c cece ....... eee eee Complications and Management................... 77 Apolipoprotein L1 Nephropathy ............... Cardiovascular Disease.................000008 77

Chronic Kidney Disease-Mineral Vascular Access and Bone Disorder.......... 0.00 cece cece eee 78 Older Patients ADGA. « ss2menm sees we baw mesme sm iee Stee we 81 End-Stage Kidney Disease Metabolig AGIGOSIS. a< 5.0: Sas meameaws wes wii ee 81 NG @HEO(GRISbo-+ss snes a eeu tmtseesess ies mites tae 82 Kidney Transplantation PYOT@IUTAG «oo woes se ee wns eens wes eeeeERs 82 Complications of End-Stage Interventions to Slow Renal Decline................ 82 Kidney Disease Protein ReStriction, «2s a:a62 mess a.a2me ec daddies 82 SMMOMNS CESSHHON 222s: wes ev emrkismsa Gr Sere: 82 Bibliography Diabetes Management...............0 eee eee 82 Special Considerations ..............000000 eee eeee 83 Self-Assessment Test Imaging Contrast Agents .................000, 83 VACCINATION: ssa < ss scemesmes a emas wees mae ws Es 83