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Causes of Enlarged Kidney : "SHAPE"
S - Sclerderma
H - HIV nephropathy
A - Amyloidosis
P - Polycystic kidney disease
E - Endocrinophathy (diabetes)

Causes of Acute renal failure (ARF): "ACUte"
A - ATN/Acute GN
C - Circulatory dysfunction (i.e. shock ,hypovolaemia, sepsis, cardiogenic)
U - Urinary outflow obstruction

Acute renal failure (ARF) Detection : "ACUte"
A - Acute presentation over hours or days
C - Creatinine rises
U - Urea rises (±oliguria <400 ml/24 hours)

Anion gap acidosis Increase "DULSI"
D : diabetic ketoacidosis
U : uremia
L : lactic acidosis
S : salicylate poisoning
I : intoxicants (methanol, ethanol, ethylene glycol )

Chronic Renal Failure Differential Diagnosis : "DUG HIPPO"
D - DM 25%
U - Unknown 12%
G - Glomerulonephritis 25%
H - Hypertension 10%
I - Interstitial nephritis 5%
P - Pyelonephritis, VUR 10%
P - Polycystic kidney disease (ADPKD)
O - Obstruction 3%

Chronic renal failure Clinical presentation : "NASER & 8 Ps"
N - Nails are brown
A - Arises blood pressure
S - Skin is yellow
E - Excoriations (scratch marks)
R - Retinopathy
P - Pallor
P - Purpura and bruises
P - Pericarditis and cardiomegaly
P - Pleural effusions
P - Pulmonary oedema
P - Peripheral oedema
P - Proximal myopathy
P - Peripheral neuropathy

Chronic vs. Acute Renal Failure : "SNAB"
S - Small kidney
N - Neuropathy
A - Anemia
B - Bone disease

Complicated urinary tract infections (UTIs) : "MARIO"
M - Male patients
A - Abnormal renal tract
R - Renal function is impaired
I - Impaired host defences
O - Organism that is virulent

Diabetes Insipidous: diagnosing subtypes : After a desmopression injection:
Concentrated urine = Cranial.
No effect = Nephrogenic.

Dialysis Complications : "CHAIR"
C - Cardiovascular disease
H - Hypertension
A - Anaemia
I - Infections
R - Renal bone disease

Dialysis Indications : "AEIOU"
A - Acid base problems (severe acidosis or alkalosis)
E - Electrolyte problems (hyperkalaemia)
I - Intoxications
O - Overload, fluid
U - Uraemic symptoms
Alternatively:
"R SHAPE"
R - Refractory pulmonary oedema
S - Severity of condition increases
H - Hyperkalaemia persistent (K+>7 mmol/l)
A - Acidosis is metabolic and worsening (pH <7.2 or base excess <10)
P - Pericarditis (uraemic)
E - Encephalopathy (uraemic)

Glomerular disease with a reduced complement level : "PELICAN"
P - Post-streptococcal glomerulonephritis
E - Endocarditis (sub-acute)
L - Lupus membranoproliferative
I - Idiopatic membranoproliferative glomerulonephritis
C - Cryoglobulinemia
A - Abscess (visceral)
N - Nephritis

Hemolytic Uremic Syndrome/Thrombotic Thromobocytopenic Purpura : "CRAFTY"
C : CNS symptoms
R : Renal failure
A : Anemia (microangiopathic hemolytic anemia, "MAHA")
F : Fever
T : Thrombocytopenia
Y : no one knows "Y" it occurs

Hematuria differential : "HEMATURIA"
H - Hereditary (PCK and OWR) / Henoch Schonlein purpura
E - Embolism (infective endocarditis)
M - Malignant HTN
A - Acute and chronic glomerulonephritis / IgA nephropathy
T - Tumors / Trauma / Toxic drugs
U - Urolithiasis
R - Renal papillary necrosis
I - Infection (pyelonephritis, cystitis, urethritis)
A - Anti-coagulants

Hematuria - urethral causes: "NUTS"
N - Neoplasm
U - Urethritis
T - Tumour
S - Stone

Hydronephrosis differential : Unilateral is
"PACT"
P - Pelvic-uteric obstruction
(congenital or acquired)
A - Aberrant renal vessels
C - Calculi
T - Tumours of renal pelvis
Bilateral is
"SUPER"
S - Stenosis of the urethra
U - Urethral valve
P - Prostatic enlargement
E - Extensive bladder tumour
R - Retro-peritoneal fibrosis

Hyperkalemia DDx: "ART x3"
Artifact (e.g. hemolytic sample)
A - ACE inhibitor
A - Addison's
R - Renal failure
R - Rhabdomyolosis
R - RTA, type I
T - Tumor lysis syndrome
T - Transcellular shift (e.g. w/ acidosis)
T - Treatment ; urgent treatment required if K+ > 6

Hypokalemia Differential Diagnosis : "BAD LOAD"
B - Barter's, Conn's (hyperaldosteronism)
A - Alkalosis
D - Diuretics
L - Laxative abuse
O - Other causes (e.g. insulin overdose)
A - Acute glucose load
D - Diarrhea

Metabolic waste products retention clinical features : "ABCDEFGHI"
A - Apathy/Anorexia/Anemia
B - Bleeding
C - Confusion/Coma
D - Dizziness
E - Emesis/Edema of the lung
F - Fits
G - Gastrointestinal bleeding
H - Hiccups
I - Infection

Nephrectomy indications : "4 Ts"
Trauma
Tumor
TB
Transplantation

Nephritic syndrome glomerular diseases commonly presenting as : "PARIS"
P : Post-streptococcal
A : Alport's
R : RPGN - including goodpastures, wegners GN
I : IgA nephropathy
S : SLE

Nephrotic Syndrome : "GREDS"
G - Glomerulonephritis
R - Renal vein thrombosis
E - Eclampsia
D - DM
S - SLE

Nephrotic syndrome causes for secondary nephrotic syndrome: "DAVID"
D - Diabetes mellitus
A - Amyloidosis
V - Vasculitis
I - Infections
D - Drugs

Normal anion gap acidosis: "USED CAR"
U : uterosigmoidostomy
S : saline administration (in the face of renal dysfunction)
E : endocrine (Addisons, spironolactone, triamterene, amiloride, primary hyperparathyroidism)
D : diarrhea
C : carbonic anhydrase inhibitors
A : ammonium chloride
R : renal tubular acidosis

Polycystic kidney: Genetic marker "P" is the 16th letter of the alphabet.

Autosomal dominant Polycystic kidney disease is associated with abberation on the 16th chromosome

Prostatism initial symptoms : "Prostatism is initially FUN"
F - Frequency
U - Urgency
N - Nocturia

Pyelonephritis (acute) predisposing factors : "SCARRIN UP"
S - Sex (females <40, males >40)
C - Catheterization
A - Age (infant, elderly)
R - Renal lesions
R - Reflux (vesciouteral)
I - Immunodeficienct
N - NIDDM, IDDM
U - Urinary obstuction
P - Pregnant
Acute pyelonephritis heals by scarring up the area (pyelonephritic scar).

Renal Cell Cancer (RCC): Genetic marker "RCC" equals three. Or, "C" is the third letter of the alphabet. RCC is associated with genetic abberations on the third chromosome (VHL gene)

Renal failure causes : "DIVA GUT"
D - Diffuse intravascular coagulation
I - Infection
V - Vascular obstruction
A - Acute tubular necrosis
G - Glomerular disease
U - Urinary obstruction
T - Tubulointerstitial nephritis

Renal tubular acidosis:

Type with common nephrocalcinosis The stONE (nephrocalcinosis) is common in type ONE

UTIs Risk factors : "UTIs"
U - Urinary tract obstruction or malformation
T - The menopause
I - Intercourse (sexual)/Instrumentation/Immunosuppression
S - female Sex/Stones
Alternatively
"SUMI"
S - female Sex/Stones
U - Urinary tract obstruction or malformation
M - Menopause
I - Intercourse (sexual)/Instrumentation/Immunosuppression

Urinary incontinence causes of acute and reversible : "DRIP"
D - Delirium
R - Restricted mobility/Retention
I - Inflammation/Infection/Impaction (fecal)
P - Pharmaceuticals/Polyuria

"Drip" is convenient since it is urinary incontinence, so urine only drips out.

Urinary incontinence differential : "DIAPERS"
D - Delirium
I - Infection
A - Atrophic urethritis and vaginitis
P - Pharmaceuticals/Psychologic
E - Excessive urine output
R - Restricted mobility
S - Stool impaction

Urinary tract malignancies , Features of renal cell carcinoma (RCC) : "RRC"
R - Renal tubule (proximal) epithelium is involved
R - Renal Cancers are 90% RCC
C - Clinical features include haematuria, loin pain, abdominal mass, anorexia, malaise and weight loss

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