Renal Flashcards
(14 cards)
What is chronic Kidney Disease?
Impaired renal function for >3months due to abnormal structure or function OR GFR <60
What is classed as end stage renal failure?
GFR<15 OR reliance on renal replacement therapy
Give 6 signs/symptoms of CKD
- Uraemia
- Bone pain due to low Ca, High PO4, High PTH
- Metabolic acidosis due to low bicarb
- Hyperkalaemia
- Oedema - salt and water retention
- Anorexia, vomiting, nausea, peptic ulceration
What are the different stages of CKD in GFR?
- > 90
- > 60
3a, 3b, 3c - > 15
- <15
What blood investigations would you perform if an eGFR is <30?
- Urine microscopy for casts/cells
- Immunology - SLE, vasculitis
- Renal USS - APKD, obstruction, reflux
- Biopsy - if indicated
Which nephrotoxic drugs must be avoided in CKD?
NSAIDs
Aminoglycosides
Radiological contrast
Give 6 risk factors associated with High risk CKD?
- Nephrotoxic drugs
- HT
- DM
- CVD
- Recent AKI/renal tract abnormality
What tests would you do for CKD?
Urine dipstick
eGFR
Blood pressure
What further detection tests would be necessary in the urine for CKD?
Protein/creatinine (PCR) OR
Albumin/creatinine ACR - more sensitive) ratios from morning spot urine sample
What urea results would you be likely to see in a patient with CKD?
Increased urea due to decreased excretion or GI bleed/high protein diet
What should patients be told before having their eGFR measured?
Do not eat meat 12hours before
What blood tests are essential in CKD?
U+Es including Ca
Phosphate
PTH
Vit. D
What further tests would you do to rule out other causes for reduced eGFR?
Urine Microscopy
Immunology - SLE, vasculitis
Renal USS - APKD, obstruction, reflux
Biospy - if indicated
In CKD, what is contraindicated for the treatment of HTN with ACEi or ARB?
Renal artery stenosis
