Chronic Kidney Disease

Question 1

CKD- intro

Answer 1

• The severity of CKD can be categorised from G1-5 depending on GFR level
• It can be classified by the degree of proteinuria (albumin/creatinine ratio) A1-3
• CKD differs from AKI- speed, recovery

Question 2

Renin-Angiotensin-Aldosterone system

Answer 2

• The RAAS has a critical role in CKD
• RAAS mainly works by regulating intra-glomerular pressures, salt and water balance
• Decrease in renal intra-arteriole pressure, decreased ultrafiltrate sodium levels and sympathetic stimulation
• Angiotensinogen =(Renin) => Angiotensin I =ACE=> Angiotensin II= stimulates aldosterone (Na+water retention) release from adrenal cortex + promotes ADH release (Na reabsorption and thurst)
• AgII also has a direct vasocontricting effect on renal arterioles- short term= increased GFR but long term results in glomeruli scarring and worsensing CKD

Question 3

CKD classification

Answer 3

Question 4

Causes of CKD

Answer 4

• Unknown
• (Chronic) Glomerulonephritis- IgA nephropathy
• Pyelonephritis
• Diabetes
• Polycystic kidneys
• HTN
• Renal vascular diease

Question 5

Clinical manifestations

Answer 5

• Polyuria/nocturia
• Proteinuria
• Haematuria
• HTN + Fluid overload
• Anaemia- EPO
• Renal oesteodystrophy- Secondary hyperparathyroidism, osteomalaciea and a mix of those