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Flashcards in CKD Deck (6):

What is the Definition of CKD?

  1. >3months (measured on 2 separate occasions): - eGFR <60L/min/1.73m2 (would recheck in 7 days to rule out AKI) 
  2. evidence of renal damage (haematuria, microalbuminuria, pathological abnormalities).


Screening for CKD?

  • only screen at risk populations between 18-30 above 30 screen every 2 years for Aboriginal and every 12months in HTN/diabetes 
    • ACR (microalbuminuria >2.5M and >3.5F (first thing in the morning))
    • eGFR Can increase due to:
      • UTI, f
      • ebrile illness,
      • dietary protein,
      • drugs (NSAIDs),
      • correct eGFR for age using CKD-EPI
    • important to rule out treatable kidney disease:
      • UTI
      • Stone
      • Autoimmune
      • Nephrotoxic drugs
      • Kidney cancer


What should you do for a CKD management plan?

Management plan:


  • All CKD is treated with ACE I or ARB plus diuretic (avoid NSAIDs and nephrotoxins) 
    • aim for >50% reduction in ACR 
  • start a statin 
  • CKD 1-3 stages reduce daily protein intake 0.75g/kg/day and restrict fluid intake 2-2.5L 
  • diabetes control <7%HbA1c 


  • CVD risk (BP, cholestrol, smoking cessation, glycemic control, decrease weight)
  • avoid nephrotoxins
  • lifestyle (salt restrict, decrease alcohol, physical activity)


  • review every 12 months with investigations (6mths if microalbumin, 3 months if CKD stage 4 or worse)
  • monitor for complications (dose adjust) 
  • add to recall practice software 

If CKD 1-2 then start thinking about RRT: 

  1.  fluid overload (diuretics/dialysis)
  2. electrolyte changes (calcium supplements, phosphate binders, resonium/frusemide),
  3. dialysis
  4. OP/osteomalacia
  5. hyperPTH
  6. HTN (ACE/ARB)
  7. anamia (darbepoetin or iron infusions) 


What are some RF modifications to stop people getting CKD? 

  • Obesity (lose weight) 
  • Diabetes control 
  • HTN control 
  • Smoking cessation 
  • healthy diet 
  • limit salt intake to <6g per day 

Tx BP with ACE I or ARB, use a statin 

Prevent children from getting rheumatic fever and prevent pregnancy complications 


What can cause an elevated urine protein but not an elevated urine albumin? 

  1. tubulointerstitial disease 
  2. multiple myeloma 


Why do you have to repeat CKD test screening? What tool should you use? 

  • CKD-EPI - measures cerum creatinine and accounts for age/gender 
  • illness, diet, weight can bias eGFR estimate 
  • repeat eGFR in 7 days to exclude AKI but also to check the legitimacy of the result. 
  • should do albumin in the morning, first pass. Repeat 2x in 3 months