Key take home messages
- Around 10% of AKI are intrinsic in nature and easily misdiagnosed.
- Blood on urine dipstick in AKI in the absence of trauma (catheterisation or UTI) should raise the suspicion of glomerulonephritis and the following screening tests sent
- DS DNA
- Anti GBM
- Serum Electrophoresis
- Urine should also be sent for spot urine protein-creatinine ratio
Involve the renal team early in any suspected glomerulonephritis or renal vasculitis as treatment is specialised and early treatment corresponds with less over all morbidity.
- Pulmonary haemorrhage should raise the suspicion for Anti-GBM disease or ANCA vasculitis amongst other differentials.
- Treatment requires specialist input and typically involves high dose steroids and cyclophosphamide as immunosuppression.