Chronic Kidney Disease (CKD) and Basic Renal Physiology Flashcards
What is the definition of CKD?
Disease impairing kidney function, causing kidney damage to worsen over several months (>6 months)
Why do advanced CKD patients need regular fluid assessment?
Oligouric or anuric
What are the main causes of CKD?
1) Diabetes Mellitus
2) HT
3) Atherosclerotic renal vascular disease
4) Congenital e.g. PKD
5) Urinary tract obstruction
What are the main signs of CKD?
Apply to function of kidneys
Proteinuria, Haematuria, Imapired eGFR, rise in serum urea/creatinine, anaemia (decreased EPO), bone disease, CV disease, polyneuropathy, ED and ^ PTH
What is the management for CKD?
1) Treat the underlying cause
2) Slow deterioration of kidney function e.g. maintain BP
3) Reduce CV risk e.g. statins, smoking cessation
4) Treat complications
5) ESRF –> Dialysis or transplant
What are the 5 main causes of haematuria?
1) Kidney tumour/trauma/stones/cysts
2) Ureteric stones/tumour
3) Bladder infection, stones and tumour
4) BPH or prostate cancer
What investigations would you do for a patient with haematuria?
1) Urinalysis
2) Urine cytology
3) Abdomen Ultrasound
4) Abdomen CT
5) Cystoscopy
What are the main functions of the Kidney?
1) Acid-base balance
2) Plasma Ca2+
3) RBC numbers (EPO)
4) Gluconeogenesis
5) Blood pressure (Renin)
6) Extra-cellular fluid volume
7) Electrolyte balance (Osmolarity)
8) Excretes waste (urea, acids and drugs)
What factors cause a decrease in GFR?
1) Increase in afferent artery resistance
2) Decrease in efferent artery resistance
3) Decrease arterial pressure (GHP)
4) ^ BCP (Urinary tract obstruction)
5) V Kf -> Renal disease
6) ^ Pressure of glomerulus w/ decrease in renal blood flow and increase in plasma proteins
What 3 factors is the GFR influenced by?
1) Net filtration pressure (Hydrostatic and Colloid osmotic pressures)
2) Renal Blood Flow (Autoregulation)
3) Filtration Coefficient (Glomerular podocytes and arteriolar endothelium)
