Chronic kidney disease

Question 1

define chronic kidney disease?

Answer 1

progressive loss of kidney function over a period of months or years

Question 2

how is CKD classified?

Answer 2

• stage 1 - GFR > 90
• stage 2 - GFR 60-89
• stage 3 - GFR 45-59
• stage 4 - GFR 30- 44
• stage 5 - GFR < 15 / on dialysis/ kidney transplant needed

Question 3

how is GFR measured?

Answer 3

• serum creatinine
• age
• gender
• ethnicity

Question 4

when can GFR measurements be skewed?

Answer 4

• body builders
• pregnancy
• eating red meat 12 hours prior

Question 5

what are the risk factors of CKD?

Answer 5

• Age
• Diabetes mellitus
• Obesity
• Hypertension
• Diabetic nephropathy
• Chronic glomerulonephritis
• Chronic pyelonephritis
• Polycystic kidney disease

Question 6

what is the epidemiology of CKD?

Answer 6

• common
• risk increases with age
• often associated with heart disease

Question 7

presenting signs of CKD?

Answer 7

- often asymptomatic 
o	Anorexia 
o	Nausea and vomiting  
o	Fatigue  
o	Pruritus  (itch) 
o	Peripheral oedema  
o	Muscle cramps  
o	Pulmonary oedema  
o	Sexual dysfunction

Question 8

signs of CDK?

Answer 8

- o	Skin pigmentation  
o	Excoriation marks (picking marks) 
o	Hypertension  
o	Peripheral oedema  
o	Peripheral vascular disease  
o	Signs of anaemia due to low EPO (pallor, aortic murmur, fatigue) 
o	Secondary hyperparathyroidism  causing low calcium signs 
o	Signs of heart disease

Question 9

which investigations should be done for CKD?

Answer 9

urea 
creatinine 
GFR 
glucose 
potassium 
antibodies 
urine analysis 
imaging 
renal biopsy

Question 10

what is the gold standard?

Answer 10

GFR (expensive)