Flashcards in Chronic kidney disease I Deck (16):
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:
- 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?
- 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