CKD

Question 1

Definition of CKD

Answer 1

a reduction in kidney function or structural damage (or both) present for >3mths
WITH associated health implications

Question 2

what mneumonic can be used to remember the ‘markers of kidney damage’

Answer 2

THE ASS
- transplant
- histological abnormalities
- electrolyte abnormalities due to tubular disorders

• ACR >3mg/mmol
  -Sediment abnormalities in the urine
  -Structural abnormalities

Question 3

what CKD stage would a patient with an eGFR of 47 be in

Answer 3

G3a

Question 4

what CKD stage would a patient with an eGFR of less than 15 be in

Answer 4

G5 (kidney failure)

Question 5

what CKD stage would a patient with an eGFR of 20 be in

Answer 5

G4

Question 6

what is the eGFR range for stage 3b CKD

Answer 6

30-44

Question 7

what is the value for severely increased urinary ACR

Answer 7

> 30mg/mmol

Question 8

2 most common aetiologies of CKD

Answer 8

• diabetes
• High BP

Question 9

potential nephrotoxic drugs

Answer 9

• aminoglycosides (e.g. gentamicin)
• ACEi
• ARBs
• bisphosphonates (e.g. alendronate)
• calcineurin inhibitors (e.g. ciclosporin or tacrolimus)
• diuretics (loop, thiazide etc)
• lithium
• mesalazine
• NSAIDs

Question 10

Complications of CKD

Answer 10

• AKI
• Hypertension and dyslipidaemia
• renal anaemia
• renal mineral and bone disorder

more complications:
- peripheral neuropathy and myopathy
- malnutrition
- malignancy
- end stage renal disease
- all-cause mortality

Question 11

CKD treatment

Answer 11

Treat underlying condition!!!
- diabetes: meet HbA1c target
- hypertension: hit BP targets
- autoimmune/multisystemic conditions: immunosuppression
- obstruction: relieve it
- nephrotoxins: stop them

Question 12

in people with CKD, what is BP targets

Answer 12

systolic below 140 (target 120-139)
diastolic below 90

if diabetes as well aim for <130/80

Question 13

what drug do we give to CKD patients for primary or secondary prevention of CVD

Answer 13

atorvastatin 20mg