Chronic kidney disease I Flashcards Preview

Year 2 Renal > Chronic kidney disease I > Flashcards

Flashcards in Chronic kidney disease I Deck (16):

definition: CKD

presence of KIDNEY DAMAGE or DECREASED KIDNEY FUNCTION for 3 or more MONTHS, irrespective of cause


kidney damage is identified by the presence of one of the following:

- albuminuria
- urinary sediment abnormalities (casts)
- electrolyte and other abnormalities due to tubular disorders
- imaging abnormalities
- kidney biopsy
- kidney transplantation


decreased kidney function is quantified as eGFR below:

60 mL / min per 1.73 m2


why is it important to identify people with CKD?

increased risk for all-cause and CV mortality, ESRD, AKI, and CKD progression


ESRD-causing polymorphisms are located in what gene? what is the inheritance pattern?

- apolipoprotein L1 (APOL1)

- autosomal recessive


APOL1 mutations are also associated with what conditions?

- earlier onset of kidney disease
- more rapid decline in eGFR


what is the most significant risk factor for CKD?



what is the gold standard exogenous filtration marker of GFR?



what are the eGFR values for CKD stages 1-5?

stage I: over 90 mL/min
stage 2: 60-89 mL/min
stage 3: 30-59 mL/min
stage 4: 15-29 mL/min
stage 5: under 15 mL/min


what are the criteria for revised stages of CKD?

- cause
- six categories of GFR
- three categories of albuminuria


what are the compensatory chances in renal hemodynamics seen in progressive renal failure?

- increased intraglomerular pressure (systemic or arteriole mediated)
- glomerular hyperfiltration in preserved nephrons


how do the maladaptive changes seen in progressive renal failure cause decline in GFR?

- direct endothelial cell damage
- formation of subendothelial hyaline deposits narrow capillary lumens, decreasing perfusion and filtration
- increased strain on mesangial cells, stimulating release of cytokines and mesangial expansion


proteinuria alone may contribute to disease progression by which mechanisms?

- mesangial toxicity
- tubular overload and hyperplasia
- toxicity from specific filtered compounds
- induction of proinflammatory molecules such as monocyte chemoattractant protein-1 (MCP) and cytokines


definition: CKD progression

- decline in GFR category
- drop in GFR category accompanied by a 25% or greater drop in eGFR from baseline


definition: rapid progression

sustained decline in eGFR of more than 5 mL/min/1.73 m2/yr


what is the management for patients with CKD progression?

- review current management
- examine for reversible causes
- consider referral