ckd

Question 1

Define

Answer 1

> 3 months of GFR<60ml/min/1.73m2

or increased Creatinine for >3months

Question 2

What equation is used to see if there is abnormal kidney function?

Answer 2

MDRD equation» takes into account: serum creatinine, age, gender, ethnicity

Question 3

Causes of CKD?

godchap

Answer 3

Glomerulonephritis
Obesity
Diabetes» causes nephropathy
Cardio disease» reduced blood to kidneys
Hypertension» damages arteries that supply blood to kidneys
Age
Pyelonephritis

Question 4

epidemiology? (1)

Answer 4

older people are more prone

Question 5

give 3 skin symptoms of CKD

Answer 5

epistaxis
skin pigmentation
pruritis

Question 6

give a blood symptom of CKD

Answer 6

anaemia» lethargy

because the kdineys are messed up so reduced production of EPO

Question 7

give 2 genital/sexual symptoms of CKD

Answer 7

amenorrhoea

erectile dysfunction

Question 8

give 2 circulatory/cardiovascular symptoms of CKD

Answer 8

heart failure» because the blood volume is reduced due to messed up RAAS
pericarditis

Question 9

give 2 renal symptoms of CKD

Answer 9

nocturia

oedema» because kidneys not good at clearing fluid from body so fluid builds up in tissues

proteinuria because the pores in the kidneys are bigger so the proteins leak out more easily into urine

Question 10

give 3 infective risk factors for CKD

Answer 10

TB, malaria, schistosomiasis

Question 11

would these blood tests be raised, lowered or normal in CKD?

a) urea
b) creatinine
c) ALP
d) eGFR
e) calcium
f) phosphate
g) Hb

Answer 11

a) high
b) high
c) high
d) low
e) low
f) high
g) low= anaemia

Question 12

What is renal osteodystrophy and how is it caused?

Answer 12

CKD causes low calcium because a lot of calcium leaks out and to compensate for low calcium in the blood, osteoclasts break down bone to release more calcium into blood.
This weakens bones

Question 13

Signs of CKD on physical examination (3)

Answer 13

Skin pigmentation
Pitting oedema 
Ascites 
Lethargy 
Pruritus

Question 14

Why oedema and ascites in CKD?

Answer 14

Because there is less protein in the blood as more protein is pushed out through bigger pores in kidneys.
Reduced oncotic pressure in the blood» less water drawn in in from tissues into blood

Question 15

App Ix of pt with Ascites and elevated creatinine and Urea etc.

Answer 15

Bloods» FBC (low hb), u&Es low calcium, high phosphate, serum creatinine is high

Urinalysis=» proteinuria, haematuria

Imaging» US kidneys (small), XR, CTKUB,

Renal biopsy» when unexplained and need to check for renal carcinoma

Question 16

Why is hyperkalaemia caused by CKD?

Answer 16

because the normal functioning of the kidneys is to pump out potassium but reabsorb sodium
Messed up kidneys are not able to pump out potassium so you get hyperkalaemia

Question 17

Why is metabolic acidosis caused by CKD?

Answer 17

Because damaged kidneys will pump out less H+ ions via urine so more H+ stays in blood»> acidosis