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3 Urinary Unit > 20 Chronic Kidney Disease > Flashcards

20 Chronic Kidney Disease Flashcards

1
Q

Define chronic kidney disease.

A

Progressive and irreversible loss of renal function over months/years

  • Functioning renal tissue replaced by extracellular matrix
    • Glomerulosclerosis
    • Tubular interstitial fibrosis
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2
Q

What are the 2 main clinical signs that indicate chronic renal failure?

A

Proteinuria

Hypertension

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3
Q

How prevalent is CKD (what % of world population estimated to have CKD and what % of Uk population)?

A

World: 11-13%

UK: 6.1%

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4
Q

List some common causes of CKD:

A
  • Diabetes (most common- UK)
  • Arteriopathic renal disease
  • Hypertension
  • Autoimmune eg glomerulonephritis
  • Myeloma, lupus
  • Infection
  • Obstructive nephropathies
  • Genetic, family history, polycystic kidneys
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5
Q

What are some risk factors for developing chronic kidney disease?

A
  • Diabetes
  • Obesity (hyperlipidaemia)
  • Cardiovascular disease
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6
Q

CKD has an effect on all of the systems in the body. Give an effect that CKD has on the following body systems:

  • CVS
  • Endocrine
  • Metabolic
  • CNS
  • Bone
A
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7
Q

List some symptoms of CKD:

A
  • Fatigue
  • Breathlessness
  • Restless legs
  • Aches and pains
  • Nausea and vomiting (uraemia)
    • Loss of appetite
  • Itchy skin
  • Chest pain
  • Seizures
  • Nocturia
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8
Q

What options does a patient have when their kidneys fail?

A
  • Haemodialysis
  • Peritoneal dialysis
  • Transplant
  • Conservative treatment
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9
Q

What are the advantages and disadvantages of peritoneal dialysis and haemodialysis?

A
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10
Q

What are the advantages and disadvantages of getting a kidney transplant?

A
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11
Q

What is adult polycystic kidney disease? (APCKD)

A
  • Autosomal dominant
  • PKD 1 or PKD 2 gene
  1. Cysts grow with age, present in adulthood
  2. Diagnosed with ultrasound
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12
Q

What complications can the cysts cause?

A
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13
Q

How is APCKD managed?

A
  • Treat hypertension- block RAAS
  • Diet- drink plenty of fluid, low salt
    • 4 litres water+ per day- fluid flushing- slows cyst growth
  • Tolvaptan
    • Vasopressin II receptor antagonist- stops water reabsorption
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14
Q

What are the stages of chronic kidney disease?

A
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15
Q

Each kidney contains about 1,000,000 nephrons. What would the number of nephrons have to decrease to until there was an insufficient numebr for survival?

A
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16
Q

If a patient is suspected to have chronic kidney disease, what blood tests should be carried out?

A
17
Q

What blood tests can be carried out to determine the cause of CKD?

A
18
Q

Apart from blood tests, what other tests can be carried out to investigate chronic kidney disease causes?

A
19
Q

Explain why a patient with CKD is likely to have nocturia

A

Small GFR but still need to get rid of same amount of solute so osmotic diuresis

Reduced concentratin ability of kidney

20
Q

CKD may result in hyperkalaemia ( if the eGFR falls below 20mls/min) What can be done to treat this?

A
  • Stop ACE-inhibitor/ANgiotensin receptor blocker
  • Avoid drugs that increase K+ (amiloride)
  • Avoid high potssium foods
21
Q

CKD may cause acidosis- how can this be treated?

A

Oral NaHCO3 tablets

22
Q

Explain how CKD can cause anaemia:

A
23
Q

How should anaemia caused by CKD be treated?

A
  • Check- sufficient iron in body
  • Then give EPO
24
Q

Why should patients with chronic kidney disease aim to reduce their phosphate intake and potentially take phosphate binders?

A

Kidneys can’t excrete sufficient phosphate

Can get phosphate deposits in joints, skin and blood

25
Q

List some of the symptoms of end stage renal disease:

A

3 Urinary Unit (23 decks)

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