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Polycystic Kidneys
Renal Transplant
Motor Neuron Disease
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Renal Transplant

Incidental findings Finger prick / lipohypertrophy suggesting DM
+ve signs 'This patient has end stage renal failure as evidenced scar in the right iliac fossa with transplanted kidney palpable' ± Bilateral masses in flanks suggesting polycystic kidney disease as aetiology. Renal replacement: Radiocephalic/brachiocephalic fistula or PD catheter/scar. Comment on whether fistula is functional and whether there is evidence of needling.
Differential diagnosis If no specific cause found 'The most common aetiologies in the UK are ...'
Function Rejection: 'The graft is non-tender, there are no scratch marks suggestive of uraemia'
Fluid balance: JVP/basal creps/able to lie flat
Immunosupression: 'There are purpora suggestive of steriod usage, multiple warts consistent with azathioprine and hypertrichosis and gum hypertrophy consistent with cyclosporine'

Extensions

Causes of end stage renal failure

Diabetes mellitus
Hypertension
Glomerulonephritis
Polycystic kidney disease

Notes

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