1. Dr Sukhvinder S. Digpal SpR Nephrology
Renal for PACES
Dr Sukhvinder S. Digpal
SpR Nephrology

2. Objectives Focus on Examination What to look for – the Signs
How to present the findings
Investigations
Problems associated with Renal Tx
History Taking Station
Communication Skills and Ethics Station

3. Presenting the case 1. Say what you see!
2. Stage of renal impairment – with supporting evidence
3. If Renal Tx present – is it active?

4. Presenting the case 4. Cause of Renal failure; 5. Fluid status
GN, Diabetes, PCKD, Obstructive, Familial, HTN, Renovascular disease, vasculitis, SLE
5. Fluid status
6. Evidence of immunosuppressive medication

5. Investigations Blood Tests Imaging Urine
CRP, UEs, FBC, LFTs, Bone profile, CO2, vasculitis screen, myeloma screen, blood cultures, genetic studies (ADPKD), drug levels
Imaging
USS Abdomen +/- renal biopsy, MRI, CT, IVU
Urine
Culture, cytology, casts, haematuria, proteinura

6. Problems associated with Renal Tx
Rejection – acute or chronic
Infections: PCP, CMV, EBV, BK
Skin malignancy, PTLD
Immunosuppressant toxicity;
Ciclosporin, Tacrolimus
Recurrence of original disease
Chronic graft dysfunction
Anaemia

7. Renal for PACES
Practice!