Chronic Kidney Disease

Question 1

What is chronic kidney disease?

Answer 1

A progressive loss of kidney function over months or years due to systemic diseases or kidney diseases.

Question 2

What are common causes of chronic kidney disease?

Answer 2

• Hypertension
• Diabetes
• Chronic glomerulonephritis
• Chronic pyelonephritis
• Chronic obstruction

Question 3

What is the significance of GFR in chronic kidney disease?

Answer 3

GFR (glomerular filtration rate) decreases as the disease progresses, indicating declining kidney function.

Question 4

What is azotaemia?

Answer 4

Increased blood urea levels and often increased creatinine levels.

Question 5

What symptoms are associated with uraemia?

Answer 5

• Fatigue
• Anorexia
• Nausea
• Vomiting
• Pruritus
• Neurological changes

Question 6

What is the intact nephron hypothesis?

Answer 6

Surviving nephrons sustain normal kidney function despite loss of nephron mass through compensatory hypertrophy and hyperfunction.

Question 7

What are the factors involved in the progression of chronic kidney disease?

Answer 7

• Glomerular hypertension
• Hyperfiltration
• Glomerulosclerosis
• Tubulointerstitial inflammation
• Fibrosis

Question 8

True or False: Most individuals with chronic kidney disease are aware of their condition.

Answer 8

False

Question 9

What is proteinuria and how does it relate to chronic kidney disease?

Answer 9

Proteinuria is the presence of excess protein in urine, indicating glomerular hyperfiltration and contributing to tubule injury.

Question 10

What is the relationship between chronic kidney disease and cardiovascular disease?

Answer 10

Chronic kidney disease is strongly associated with cardiovascular disease, often leading to death from cardiovascular causes.

Question 11

What are the common clinical manifestations of chronic kidney disease?

Answer 11

• Hypertension
• Anorexia
• Nausea
• Vomiting
• Weight loss
• Oedema
• Anaemia

Question 12

What happens to creatinine clearance in chronic kidney disease?

Answer 12

As GFR decreases, blood creatinine levels increase.

Question 13

Fill in the blank: Metabolic acidosis develops when GFR decreases to less than _______.

Answer 13

20% to 25% of normal

Question 14

What is CKD-MBD?

Answer 14

Chronic kidney disease metabolic bone disorder, resulting from alterations in calcium and phosphate metabolism.

Question 15

What are the three components of alterations to the musculoskeletal system in chronic kidney disease?

Answer 15

• Bone turnover
• Bone mineralisation
• Bone volume

Question 16

What are the four types of renal osteodystrophy?

Answer 16

• Osteomalacia
• Adynamic bone disease
• Osteitis fibrosa
• Mixed uraemic osteodystrophy

Question 17

How does chronic kidney disease affect potassium balance?

Answer 17

Tubular secretion of potassium increases until oliguria develops, potentially leading to life-threatening potassium levels.

Question 18

What is the role of angiotensin II in chronic kidney disease?

Answer 18

Angiotensin II promotes glomerular hypertension and hyperfiltration, worsening kidney injury.

Question 19

What are some systemic effects of uraemia?

Answer 19

• Pro-inflammatory state
• Increased morbidity
• Various systemic symptoms

Question 20

True or False: Chronic kidney disease can lead to osteoporosis.

Answer 20

True

Question 21

What dietary considerations are important for individuals with chronic kidney disease?

Answer 21

Maintaining dietary intake to prevent sodium deficits and volume depletion.

Question 22

What is the common cause of metabolic acidosis in chronic kidney disease?

Answer 22

Decreased hydrogen ion elimination and decreased bicarbonate reabsorption.

Question 23

What is the effect of chronic kidney disease on fluid and electrolyte balance?

Answer 23

Significant disturbance, leading to sodium and water retention, contributing to oedema and hypertension.

Question 24

What is a major cause of morbidity and mortality in chronic kidney disease?

Answer 24

Cardiovascular disease

It is significantly influenced by proinflammatory mediators, oxidative stress, and metabolic derangements.

Question 25

What contributes to hypertension in chronic kidney disease?

Answer 25

Excess sodium and fluid volume ## Footnote Elevated renin stimulates secretion of aldosterone, increasing sodium reabsorption.

Question 26

What are the consequences of elevated renin in chronic kidney disease?

Answer 26

Increased secretion of aldosterone, leading to sodium reabsorption ## Footnote This results in hypertension.

Question 27

What promotes the formation of atherosclerosis in chronic kidney disease?

Answer 27

Hyperlipidaemia ## Footnote It leads to endothelial cell dysfunction and vascular calcification.

Question 28

What is a consequence of declining erythropoietin production in chronic kidney disease?

Answer 28

Anaemia ## Footnote This increases the demand for cardiac output and adds to cardiac workload.

Question 29

What can develop from inflammation caused by uraemic toxins?

Answer 29

Pericarditis ## Footnote It can cause accumulation of fluid in the pericardial space, compromising cardiac function.

Question 30

What are common haematological alterations in chronic kidney disease?

Answer 30

1. Normochromic-normocytic anaemia 2. Impaired platelet function 3. Hypercoagulability ## Footnote These contribute to increased bleeding tendency and risk for cerebrovascular events.

Question 31

What is a common neurological symptom of chronic kidney disease?

Answer 31

Headache ## Footnote Other symptoms may include drowsiness, sleep disorders, and memory loss.

Question 32

What are gastrointestinal complications associated with chronic kidney disease?

Answer 32

1. Uraemic gastroenteritis 2. Anorexia 3. Nausea 4. Vomiting 5. Constipation or diarrhoea ## Footnote Uraemic fetor is also a notable symptom.

Question 33

What endocrine alterations occur with chronic kidney disease?

Answer 33

1. Decrease in circulating sex hormones 2. Insulin resistance 3. Alterations in thyroid hormone metabolism ## Footnote These affect both males and females differently.

Question 34

What is a common skin change associated with chronic kidney disease?

Answer 34

Pallor and bruising ## Footnote These are due to anaemia and uraemic skin residues.

Question 35

What is a key marker of kidney damage in chronic kidney disease evaluation?

Answer 35

Urine protein, particularly albumin ## Footnote Elevated blood creatinine and urea concentrations also indicate kidney damage.

Question 36

What is the mainstay of management for chronic kidney disease?

Answer 36

Dietary control ## Footnote This includes protein restriction and management of fluid, sodium, potassium, and phosphate.

Question 37

What medication is often used for renal protection in chronic kidney disease?

Answer 37

Angiotensin-converting enzyme (ACE) inhibitors ## Footnote They also help control systemic hypertension.

Question 38

True or False: Insulin's effects are prolonged in chronic kidney disease.

Answer 38

True ## Footnote The kidney's ability to degrade insulin is reduced.