Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (545 page)

   Acute: abrupt onset of hematuria, proteinuria (non-nephrotic range), severe hypertension, and severe normochromic, normocytic anemia.

   Chronic: stable isolated proteinuria, mild to moderate hypertension and slow progression to renal failure.

RENAL ABSCESS

See Urinary Tract Infections in Chapter
7
, Genitourinary System Disorders

RENAL ARTERY STENOSIS

   Definition

   Narrowing of one or both renal arteries or their branches.

   Caused by atherosclerosis and, less frequently, by fibromuscular dysplasia.

   Often leads to hypertension and chronic renal insufficiency. Ischemic nephropathy with irreversible parenchymal damage and renal failure may also occur.

   Who Should Be Suspected?

   Candidates include patients with new-onset hypertension, rapid blood pressure swings, or increase in severity of known hypertension, especially if it becomes refractory to antihypertensive therapy.

   Old age, other atherosclerotic lesions, and the presence of chronic kidney disease are risk factors.

   Laboratory Findings

   Laboratory findings are nonspecific. Diagnosis is established by imaging studies.

   Mild proteinuria is common.

   BUN and creatinine may show recent increase.