Session 11 - Chronic Kidney Disease Flashcards Preview

Semester 3 - Urinary > Session 11 - Chronic Kidney Disease > Flashcards

Flashcards in Session 11 - Chronic Kidney Disease Deck (60)
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1

Define chronic kidney failure

• The progressive and irreversible loss of renal function over a period of months to years

2

What is the underlying pathology of chronic kidney failure?

• Function renal tissue is replaced by extra-cellular matrix, which gives rise to glomerulosclerosis and tubular intersitial fibrosis

3

What does a diseased kidney do?

• Shrinks
• Fibrosis

4

What does chronic kidney failure result in?

• Progressive loss of both the excretory and hormone functions of the kidney
• Proteinuria and systemic hypertension develops

5

Give 8 causes of chronic kidney disease

I gave GOD HIV
• Immunologic
○ Glomerulonephritis
• Infection
○ Pyelonephritis
• Genetic
○ Polycystic Kidney Disease (PCK)
○ Alport’s Syndrome
• Obstruction and reflux nephropathy
• Hypertension
• Vascular
• Systemic Disease
○ Diabetes
○ Myeloma
• Cause unknown

6

What are the three most common causes of chronic kidney disease

• Diabetes mellitus
• Hypertension
• Glomerulonephritis

7

What do most patients with CKD have?

• Diabetes
• Hypertension
• Ischaemic Heart Disease

8

What is polycystic kidney disease?

• Multiple cysts appear on the kidney

9

What is Alport syndrome?

• Hereditary nephritis caused by an x-linked mutation
• Proliferating and sclerosing kidney disease

10

How is Chronic Kidney Disease classified?

• By amount of GFR fall and kidney disease

11

How many stages of chronic kidney disease are there?

5

12

What is stage 1 of chronic kidney disease? GFR, description, clinical diagnosis, %population

• >90 GFR
• Kidney damage with normal or increased GFR
• Need other evidence of kidney damage

3.3% population

13

What is stage 2 of chronic kidney disease? GFR, description, clinical diagnosis, %population

• 60-89% GFR
• Kidney damage with mild GFR fall
• Need other evidence of kidney dmage
• 3% population

14

What is stage 3 of chronic kidney disease? GFR, description, clinical diagnosis, %population

• 30-59% fall in GFR
• Moderate fall in GFR
• Symptoms +/-

6% population

15

What is stage 4 kidney disease?

• 15-29%
• Severe fall in GFR
• Symptoms ++
• 0.2% population

16

What is stage 5 kidney disease

• <10ml/min GFR
• 0.1% population

17

What is the incidence of CKD?

• 85% have diabetes, hypertension or ischaemic heart disease
• More common in the elderly, ethnic minorities and the socially disadvantaged

18

Why don't most patients with CKD end up needing dialysis?

High cardiovascular mortality at all stages of CKD

19

Give four systems affected by CKF

• CVS
• Haematological
• Musculoskeltal
• CNS

20

What does CKF cause in the CVS system?

• Atherosclerosis
• Cardiomyopathy
• Pericarditis

21

What does CKF cause in haemotologically

○ Decreased erythropoietin
○ Resistance to erythropoietin
○ Decreased RBC survival

Blood loss

22

Where is erythropoietin produced?

The interstitial fibroblasts in the kidney, in close assocaiation with peritublar capillaries.

23

What does CKF cause in the bone?

• Renal bone disease

24

Give two forms of renal bone disease

• Decreased GFR means less phosphate is excreted, increasing serum conc. Then forms complexes with free Ca2+, reducing effective serum conc. Stimulated PTH release, causing overactivity of osteoclasts - Osteitis Fibrosa Cystica
• Less Vitamin D hydroxylated to Calcitriol, causing hyperparathyroidism and osteomalacia

25

Where does hydroxylation of vitamin D occur?

• First step in the liver - prohormone calcifedol

Second step in the kidney

26

Give three CNS symptoms of CKD

• Neuropathy
• Seizures
• Coma

27

Give three general symptoms of CKD?

• Tiredness
• Breathlessness

Restless legs

28

How likely is a patient to require dialysis compared to their changes of having a CVS event?

• More likely to have CVS event than to require dialysis

29

What is a normal range of GFR?

• 80-120 ml/min

30

How can you compare current GFR of patient to normal GFR?

• % of normal GFR
• Use inulin clearance of 24hr creatinine clearance