Chronic Kidney Disease Flashcards
what is CKD
permanent and progressive damage of kidneys
RF
diabetes
hypertension
renal issues
toxic medications
top causes
diabetes
hypertension
glomerulonephritis
polycystic kidney disease
investigations
eGFR
ACR
criteria:
eGFR < 90 + renal incompetence
eGFR <50 (this value 2/3 times in the space of 3 months)
renal incompetence - proteinuria, haematuria, USS damage
management
manage underlying cause
slow renal/cardio disease
statin - preventative measure for CVD
give ACEI + monitor K levels
end stage disease:
dialysis
renal transplant
when to refer
offered 4 antihypertensives eGFR <30 ACR >70 CKD stage 4/5 rapid progression of kidney problems
complications
mineral bone disease
anaemia
acidosis
hyperkalaemia
mineral bone disease and how can it be managed
can develop secondary hyperparathyroid deficiency
reduce phosphate in diet
reduce phosphate medically
vit D supplements
what are the signs of secondary parathyroid deficiency
low Ca
high Phosphate
what can develop from secondary parathyroid deficiency and what are the signs
tertiary hyperparathyroid deficiency
parathyroid nodule developed
signs:
high parathyroid hormone
high calcium
what kind of anaemia is seen and how is it managed
normocytic
reduced erythropoietin
managed any Fe deficiency
injection of erythropoietin
what can be seen on the USS of kidneys
bilateral shrunken kidneys
CKD staging
1 - eGFR >90 + RI or albuminuria 2 - eGFR 60-90 + RI 3a - eGFR 45-59 + RI 3b - eGFR 30-44 + RI 4 - eGFR 15-29 + RI 5 - eGFR <15
what is the criteria for ACEI
give when CKD and hypertension are present
if ACR>70, give it no matter what
what can be raised in CKD
BNP
