CKD Flashcards
1
Q
What is the definition of CKD?
A
Longstanding progressive impairment in renal function
>3 months evidence of kidney damage
Creatinine from >1.5 times from baseline
Urine output from <0.5mL/kg/h >6h
2
Q
What is the pathology of CKD?
A
- Kidney damage:
- Proteinuria
- Haematuria
- Anatomical abnormality
- Impaired GFR
- Leads to:
- Fibrosis of tubules, glomeruli and small blood vessels
- Progressive renal scarring
- Classified from stage 1-5
3
Q
What are the risk factors/aetiology of CKD?
A
- Age
- Diabetes
- Hypertension
- Obesity
- Smoking
- Cardiovascular disease
- Atherosclerotic renal vascular disease
- Schistosomiasis – common in the middle east
- Polycystic kidney disease
- Glomerulonephritis
4
Q
What are the signs/symptoms of CKD?
A
- Nocturia
- Polyuria
- Oedema
- Pallor
- Lethargy
- Breathlessness of exercise
- Epistaxis
- Bruising
- Pruritus
- Hyperparathyroidism
- Bone pain
- Osteomalacia
- Peripheral paraesthesia and weakness
- Autonomic dysfunction – postural hypotension and disturbed GI motility
- Depressed cerebral function
- Myoclonic twitching and fits
- Median tunnel compression
- Amenorrhoea
- Erectile dysfunction
- Infertility
5
Q
What investigations are conducted for suspected CKD?
A
FBC • ↓ RBC • ↑ ERS • U&E’s • ↑ Urea • ↑ Creatinine • ↑ potassium • ↓ HCO3 = metabolic acidosis • ↓ Ca • ↑ phosphate • ↓ Vit D • ↑ PTH • ↓ eGFR • Urine dipstick • ↑ blood • ↑ protein • US • Renal biopsy
6
Q
What are the surgical treatments for CKD?
A
Dialysis
7
Q
What are the pharmacological treatments for CKD?
A
- ACE inhibitor/Angiotensin receptor antagonist/Ca channel blocker
- Diuretic
- Statins
- Calcium carbonate – for hyperphosphateaemia
- Vit D
- Recombinant human erythropoietin
- Oral sodium bicarbonate
- Influenza/pneumococcal vaccination
8
Q
What are the non pharmacological treatments for CKD?
A
- TREAT UNDERLYING CAUSE AND COMPLICATIONS
- Reduce drug doses
- Smoking cessation
