CKD

Question 1

Which has better prognosis - dialysis or kidney transplant

Answer 1

Transplant

Question 2

Living donor vs deceased 5 year survival?

Answer 2

90% vs 80%

Question 3

Is there a benefit from early dialysis? (>15 eGFR)

Answer 3

No, start after uraemic symptoms (usually 8-12 eGFR) but higher if cannot tolerate fluid overload

Question 4

Better prognosis - dialysis then transplant vs preemptive transplant

Answer 4

Preemptive

Question 5

Time for arteriovenous fistula to become arterialised?

Answer 5

3-6 months

Question 6

Patients with heart failure tolerate which type of dialysis better?

Answer 6

Peritoneal

Question 7

What type of fluid is used for peritoneal dialysis

Answer 7

Dextrose

Question 8

Complication of acquired renal cystic disease?

Answer 8

Renal cell carcinoma

Question 9

What symptoms does acquired renal cystic disease cause?

Answer 9

Usually none. Possibly flank pain or haematuria

Question 10

Considerations for screening of kidney donors?

Answer 10

Diabetes, heart disease, psychosocial factors, hypertension

Question 11

BK virus causes?

Answer 11

Infection in kidney transplant recipients.

Question 12

When and how to test for bk virus?

Answer 12

Declining kidney function post transplant. PCR but biopsy needed for definitive diagnosis

Question 13

Which infections can cause problems after kidney transplant

Answer 13

CMV, BK virus

Question 14

What confers high risk of CMV infection post transplant

Answer 14

Donor +ve serology, recipient -ve

Question 15

UTI can be prophylactically prevented post transplant with bactrim - T/F?

Answer 15

True, higher risk of UTI for 6 months

Question 16

What cancer are transplant recipients at risk of?

Answer 16

Post transplant lymphoproliferative disease

Question 17

Post transplant lymphoproliferative disease is associated with which virus?

Answer 17

EBV

Question 18

Which skin cancer is at higher risk in those on immunosuppressive agents post transplant

Answer 18

SCC, especially for those on azathioprine. Patients should avoid UV light

Question 19

Kidney transplant always cures CKD metabolic bone disease? T/F

Answer 19

False. Persistent post transplant hyperparathyroidism is common

Question 20

How soon post transplant can recipients receive vaccines?

Answer 20

6 months. Never for live viruses

Question 21

Kidney transplant confers increased risk of cardiovascular disease T/F

Answer 21

True

Question 22

ACE\arb has been shown to worsen progression in mod-sev CKD

Answer 22

False