Showing 1-20 of 33 for: Essential Evidence Topics > Renal 
- Acute kidney injury
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Adequate hydration, maintenance of adequate circulating volume (mean arterial pressure), and avoidance of nephrotoxins are the cornerstones of prevention. Specific prevention efforts are controversial. Best evidence for preventing c
- Bladder tumors
Essential Evidence Topics, 24-Dec-2021
Overall Bottom Line: The most common presenting symptom of bladder tumor is painless hematuria. Cystoscopy and transurethral resection of the tumor are the best procedures for diagnosis and pathologic staging. The natural history of nonmuscle invasive
- Chronic kidney disease
Essential Evidence Topics, 9-Dec-2022
Overall Bottom Line: Current guidelines recommend screening for chronic kidney disease (CKD) in patients at higher risk (such as hypertension or diabetes mellitus) using a urine assay assessing protein excretion and a serum creatinine to calculate an esti
- Coma
Essential Evidence Topics, 23-Jul-2021
Overall Bottom Line: Oxygenation via simple airway manouvers followed by early intubation and ventilation is imperative for coma due to traumatic brain injury. Intubation should also be considered in all other causes of coma. Mechanically ventilated pat
- Diabetic nephropathy
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: While guidelines recommend that patients with type 1 DM (T1DM) for >5 years and all patients with type 2 DM (T2DM) be screened annually for microalbuminuria and with a glomerular filtration rate (GFR) estimate, evidence that this r
- Dysuria
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: Symptoms of dysuria plus a positive dipstick test result for nitrites is best to rule in UTI. Healthy women complaining of dysuria may be phone triaged and empirically treated for a UTI. Women reporting vaginal discharge/odor or a
- Enuresis (childhood)
Essential Evidence Topics, 18-Aug-2021
Overall Bottom Line: Consider enuresis in any child who was dry and begins wetting or who urinates into clothes or bed at least twice a week for 3 months after 5 years of age. Use history and physical to exclude associated symptoms and conditions includi
- Glomerulonephritis
Essential Evidence Topics, 9-Dec-2021
Overall Bottom Line: Glomerulonephritis (GN) is a group of uncommon and disparate diseases, usually immunologically mediated, with some common pathophysiologic and clinical features. Suspect GN with new-onset secondary hypertension, azotemia, hematuria
- Hematuria
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: The United States Preventive Services Task Force and Canadian Task Force on the Periodic Health Examination do not recommend routine screening of urine for microscopic hematuria. Evaluation of hematuria depends on whether it is micr
- Hemolytic uremic syndrome
Essential Evidence Topics, 26-Dec-2022
Overall Bottom Line: Suspect hemolytic uremic syndrome (HUS) in patients with hemolysis, thrombocytopenia, and renal failure. If HUS is suspected, evaluate for antecedent infection by Shiga toxin-producing organisms or invasive Streptococcus pneumoniae
- Henoch-Schonlein purpura
Essential Evidence Topics, 14-Nov-2019
Overall Bottom Line: Suspect Henoch-Schonlein purpura (HSP) in children with palpable purpura and abdominal pain, joint pain, proteinuria, or hematuria. Routine testing should include vital signs, CBC, urinalysis, and stool for occult blood; consider ab
- Hepatorenal syndrome
Essential Evidence Topics, 18-Jun-2021
Overall Bottom Line: The diagnosis of hepatorenal syndrome in a patient with acute or chronic liver disease is based on elevated creatinine levels or reduced creatinine clearance after excluding other forms of underlying intrinsic kidney disease. Patien
- Hydronephrosis in infants
Essential Evidence Topics, 10-Mar-2021
Overall Bottom Line: Causes of antenatal hydronephrosis range from transient physiologic changes to severe underlying pathology; therefore, a thorough evaluation is warranted. Perform postnatal ultrasounds during the first week and first month of life i
- Hypertensive nephropathy
Essential Evidence Topics, 5-May-2021
Overall Bottom Line: Hypertensive nephropathy, or nephrosclerosis, is defined as glomerulo-vascular damage due to chronic hypertension. Suspect hypertensive nephropathy in patients with incidental findings of microscopic hematuria, proteinuria during rou
- Incontinence (male)
Essential Evidence Topics, 8-Nov-2022
Overall Bottom Line: Urinary incontinence in men is typically diagnosed by history; a micturation diary may aid in assessing severity. A urinalysis and post-void residual are recommended to rule out some reversible causes. Treat any underlying cause o
- Interstitial cystitis
Essential Evidence Topics, 15-Apr-2021
Overall Bottom Line: Consider "painful bladder syndrome" and interstitial cystitis (IC) in the patient with otherwise unexplained pelvic area pain, urinary frequency, and urgency. Confirm diagnosis with cystoscopy. Oral therapy with pentosan polysulfa
- Interstitial nephritis
Essential Evidence Topics, 17-Apr-2019
Overall Bottom Line: Many patients with acute interstitial nephritis present only with an elevated BUN-to-creatinine ratio and vague or no symptoms. In a patient with suspected acute interstitial nephritis, withdrawal of offending medications is the fir
- Polycystic kidney disease
Essential Evidence Topics, 28-Sep-2020
Overall Bottom Line: Polycystic kidney disease (PKD) is an inherited disorder that primarily affects the kidneys resulting in the formation of multiple fluid filled cysts, along with a variety of extrarenal manifestations. It is broadly divided into 2 for
- Porphyria
Essential Evidence Topics, 28-Jul-2021
Overall Bottom Line: Suspect acute hepatic porphyrias in patients with episodic abdominal pain and neuro-psychiatric symptoms. Elevated excretion of porphyrins on 24 hour urine, supplemented by fecal and serum porphyrins, is the diagnostic tests of choi
- Prostatitis (acute)
Essential Evidence Topics, 24-Dec-2021
Overall Bottom Line: The diagnosis is made via urinalysis after signs of a lower urinary tract infection; urinary and systemic symptoms are present along with a tender prostate. Urine culture should be performed to ensure appropriate antibiotic coverage
