Chronic kidney disease I Flashcards Preview

Year 2 Renal > Chronic kidney disease I > Flashcards

Flashcards in Chronic kidney disease I Deck (16):
1

definition: CKD

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

2

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

3

decreased kidney function is quantified as eGFR below:

60 mL / min per 1.73 m2

4

why is it important to identify people with CKD?

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

5

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

- apolipoprotein L1 (APOL1)

- autosomal recessive

6

APOL1 mutations are also associated with what conditions?

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

7

what is the most significant risk factor for CKD?

diabetes

8

what is the gold standard exogenous filtration marker of GFR?

inulin

9

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

10

what are the criteria for revised stages of CKD?

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

11

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

12

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

13

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

14

definition: CKD progression

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

15

definition: rapid progression

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

16

what is the management for patients with CKD progression?

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