Presentation of Kidney Disease Flashcards
(22 cards)
how can a patient present
asymptomatic (common), loin pain or urinary symptoms, haematuria, proteinuria, hypertension, AKI, CKD, nephrotic or nephritic syndrome
what are functions of the kidney
excretion of waste (urea), fluid balance, electrolyte balance, acid-base balance, vitamin d metabolism/phosphate excretion, produce erythropoietin, drug excretion, barrier to loss of protein
what can impaired excretion of waste (urea) cause
uraemia
-nausea, pericarditis, encephalopathy, neuropathy
what does impaired fluid balance cause
fluid retention (oedema) and polyuria
what does impaired electrolyte balance cause
hypokalaemia and arrhythmia
what does impaired acid-base balance cause
metabolic acidosis and Kussmaul’s respiration
what does impaired vitamin d metabolism/phosphate excretion cause
renal bone disease and valvular calcification
what does impaired erythropoietin production cause
anaemia
what drugs can cause drug toxicity if they kidneys can’t clear them properly
digoxin, gabapentin, opiates
what can happen if the barrier to protein loss doesn’t function
proteinuria and nephrotic syndrome
what antibiotics are important to ask about
gentamicin, trimethoprim, penicillins
what is accelerated hypertension
medical emergency
what is the boundary for accelerated hypertension
diastolic bp>120mmhg
what can accelerated hypertension cause
papilloedema and end organ decompensation
what is the best measure of kidney function
GFR
what is stage one CKD
over 90 GFR
kidney damage
what is stage two CKD
60-90 GFR
kidney damage
what is stage three CKD
30-60 GFR
moderate
what is stage four CKD
15-30 GFR
severe
what is stage five CKD
under 15 GFR
kidney failure
what is an acute kidney injury
decline in GFR over hours/days/weeks
with or without oliguria
in a patient with normal or impaired baseline renal function
what is oliguria
less than 400ml urine a day
