2 - Signs of Renal Disease Flashcards
In general, what are some common presentations of kidney disease?
- Tired
- Trouble sleeping
- Dry and itchy skin (white specks on scalp)
- Nocturia
- Haematuria
- Foamy urine
- Persistent puffiness around the eyes
- Swollen feet and ankles
- Poor appetite
- Muscle cramps
What are some different ways that you may discover a patient has kidney disease?
History is really important, e.g may have SLE and think itching etc is due to this but could be masking kidney disease
What is important to exam when looking at a patient with renal disease?
Why is end stage renal kidney disease dangerous?
Hyperkalemia, which could lead to V Fib
What are some symptoms of ESRD (end stage of CKD)
Usually if young may be benign clinical picture, symptoms depend on co-morbidities
Symptoms due to uraemia and the toxins
What are some signs of ESRD?
What is the definition of ESRD?
Fifth and final stage of CKD where there is irreversible damage to the kidneys, the only cure is dialysis or transplant. 5-10% kidney function
What are some of the roles of the kidneys?
How does potassium homeostasis occur?
- Some unregulated loss in kidneys
- Can ingest a large excess
- Actual balance controlled by the kidneys. If too high or low >8 or <3, fatal arrhythmias
Why are patients with severe CKD vitamin D deficient?
25-hydroxyvitamin d-1 alpha hydroxylase is produced in the proximal tubule of the kidneys, which is needed for activatin of Vitamin D, calcitriol (Active Vit D3)
What cells in the kidney produce erythropoietin?
Interstitial fibroblasts in the peritubular capillary and proximal convoluted tubule
What is a cause and effect relationship involving kidney disease?
What is the main issue that can occur involving the kidneys when you have SLE?
- Glomerulonephritis (especially diffuse proliferative) which can lead to renal failure without treatment
- Symptoms often mistake for SLE symptoms
Why may someone have musculoskeletal pain with CKD?
Calcium, Phosphorus and Vitamin D deficiency
Why do patients with CKD present with the following symptoms:
- Tired?
- Trouble sleeping?
- Dry itchy skin?
- Anaemia and build up of toxins and impurities in the blood
- Toxins in blood. Also co-morbidity of obesity leading to sleep apnea
- Mineral and bone diease as kidney can’t keep the right balance of nutrients
Why do patients with CKD present with the following symptoms:
- Nocturia?
- Haematouria?
- Foamy urine?
- Glomeruli damaged increasing urge to urinate (could be UTI or BPH)
- Glomeruli damaged so RBC leak out (could be UTI, malignancy, infection or kidney stones)
- Albumin and proteins in the urine as glomeruli damaged
Why do patients with CKD present with the following symptoms:
- Puffy eyes?
- Swollen feet and ankles?
- Poor appetite?
- Muscle cramps?
- Early sign. Due to large amount of protein leaking into urine
- Sodium retention (also due to heart, liver and vein disease)
- Build up of toxins
- Electrolyte imbalances
