14 - CKD Flashcards Preview

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Flashcards in 14 - CKD Deck (9):
1

4 parts of the final common pathway of CKD

glomerular sclerosis
tubular atrophy
interstitial fibrosis
vasculosclerosis

2

gross pathologic changes in CKD

contracted kidneys
thin renal cortex
multiple cysts (acquired cystic dz)

3

4 main interventions to slow progression of CKD

control glomerular pressure
low protein diet
BP control
ATII axis control

4

benefit of low protein diet in CKD

lowers glomerular pressure

5

3 main causes of ESRD

DM
HTN
glomerulonephritis

6

results of renal failure (lab findings)

high BUN and Cr
fluid retention
hyponatremia
hyper/hypo kalemia
acidosis
hyperphosphatemia
low Vit D > hypocalcemia
anemia
hypoglycemia etc

7

ESRD symptoms

tired, apathy, itching, copper penny taste
N/V anorexia, wt loss
pericarditis, uremic myocarditis
peripheral nerve inc conudction time, axonal loss, demyelination
paresthesia, restless leg syndrome, cramps
confusion, eventually coma/seizures

8

ESRD management

Na restriction / diuretics
cinacalcet, phosphate binders, limit PO4 intake (complicated to balance Ca vs PO4 vs bone dz)
EPO (goal Hgb 10-12)
dialysis (avoid as long as possible)

9

indications for dialysis

GFR ~10
can wait if stable or gaining weight (not from edema), good protein intake, no signs of uremia
earlier initiation may be better for diabetics (GFR ~15)