Renal & Urology

Acute kidney injury is a measurable fall in kidney filtration or urine output caused by reduced perfusion, intrinsic renal disease or obstruction; identify the cause early, protect the kidneys, monitor complications and escalate for refractory life-threatening physiology.

Acute pyelonephritis is an upper urinary tract infection involving the renal pelvis and parenchyma; fever, loin pain and systemic upset are the key clues, while sepsis or an obstructed infected system makes it an emergency.

Benign prostatic enlargement can narrow the bladder outlet and produce mixed lower urinary tract symptoms, but symptom severity, bladder function and complications—not prostate size alone—determine management.

Bladder cancer most often presents with painless haematuria; cystoscopy and TURBT establish the diagnosis and depth of invasion, separating non-muscle-invasive disease from muscle-invasive disease that needs specialist radical-treatment planning.

Diagnose CKD by persistent reduced GFR or a marker of kidney damage, stage it with eGFR and ACR, then reduce cardiovascular and kidney-failure risk through blood-pressure control, renoprotective treatment, monitoring and timely renal referral.

Kidney failure is stage 5 chronic kidney disease with insufficient renal function to maintain homeostasis; care is planned around symptoms, biochemical complications, patient goals and the choice between dialysis, transplantation and supported conservative management.

Glomerulonephritis is a pattern of glomerular injury that may present with haematuria, proteinuria, oedema, hypertension or acute kidney injury; active urine sediment with rapidly worsening renal function needs urgent nephrology assessment.

Hydronephrosis is dilatation of the renal collecting system, usually caused by impaired urine drainage; localise the cause, protect renal function, and treat an infected obstructed kidney as a urological emergency.

Raised extracellular potassium partially depolarises cardiac myocytes and slows conduction, so the lethal risk is arrhythmia and cardiac arrest rather than the number on the result.

Hypernatraemia is usually a deficit of water relative to sodium; assess volume status and urine concentration, restore circulation first if shocked, then replace water in a controlled specialist-led plan.

Hypokalaemia is a serum potassium below 3.5 mmol/L, usually from gastrointestinal or renal loss or a transcellular shift; assess the ECG and symptoms urgently, replace potassium safely, correct magnesium and treat the cause.

Hyponatraemia is a low serum sodium, usually reflecting excess water relative to sodium; assess symptoms and osmolality urgently, treat severe neurological symptoms immediately, then classify the cause and control the rate of correction.

Nephrotic syndrome is a glomerular protein-leak state causing heavy proteinuria, hypoalbuminaemia and oedema, with important risks of thrombosis, infection, acute kidney injury and progressive kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited cystic kidney disorder causing enlarged kidneys, hypertension and progressive CKD, with important renal, hepatic, vascular, reproductive and family implications.

Prostate cancer is often silent while confined to the peripheral zone; PSA and DRE trigger assessment, mpMRI precedes biopsy, and PSA, grade group and stage determine whether surveillance, radical treatment or systemic therapy is appropriate.

Renal cancer is usually renal cell carcinoma arising in the renal parenchyma; it is often found incidentally, while visible haematuria, venous invasion or paraneoplastic features should trigger urgent staging and uro-oncology assessment.

A ureteric stone causes severe colicky loin-to-groin pain by obstructing urine flow and triggering ureteric spasm; fever, anuria, renal impairment or a solitary kidney changes this into an urgent urological pathway.

Skeletal muscle necrosis floods the circulation with creatine kinase, myoglobin, potassium and phosphate: myoglobin obstructs and poisons the renal tubules, while potassium can stop the heart within hours.

Testicular cancer is usually a germ-cell tumour presenting as a persistent intratesticular mass in a young adult; urgent ultrasound, tumour markers and radical inguinal orchidectomy establish the diagnosis, while stage-directed specialist treatment achieves very high cure rates.

Rotation of the spermatic cord obstructs venous outflow and then arterial inflow, so the testis infarcts within hours unless it is surgically untwisted.

Urinary incontinence is involuntary urine leakage; the pattern—effort-related, urgency-related, mixed, continuous or dribbling from retention—identifies the mechanism and determines whether pelvic-floor training, bladder training, medicines, catheterisation or specialist treatment is appropriate.

Urinary retention is failure to empty the bladder: acute retention is usually painful and needs prompt drainage, while chronic retention may be painless but can cause overflow, hydronephrosis and acute kidney injury, so the cause, residual volume and upper-tract risk determine urgency.

Diagnose UTI from the clinical syndrome and appropriate urine testing, distinguish lower infection from pyelonephritis and sepsis, and tailor antibiotics to age, pregnancy, renal function, culture and local resistance.