30. Chronic renal disease.

Question 1

Chronic Kidney Disease

Etiology

Answer 1

• before 10 years of age:
  
  • CAKUT are the most common cause
• after age 10
  
  • acquired renal diseases are most common
    
    • such as focal segmental glomerulosclerosis and glomerulonephritis

Question 2

Chronic Kidney Disease

Clinical manifestations

Answer 2

• depends on underlying cause and complicatoins
• CAKUT:
  
  • Polyuria, Polydipsia, recurrent UTI
• glomerular disease:
  
  • Hematuria, Proteinuria, Edema, Hypertension

Question 3

Chronic Renal Disease

Complications

Answer 3

1. Poor growth
2. Anemia
3. CKD-Mineral Bone Disorder/ secondary hyperparathyroidism
4. Cardiovasclular
   
   • Hypertension
   • Left ventricular hypertrophy
5. Electrolyte abnormalities
   
   • Hyperkalemia
   • Hyponatremia
   • Metabolic acidosis

Question 4

Chronic Renal Disease

Complication Treatment:

Poor growth

Answer 4

• Increased caloric intake,
• treat acidosis
• treakt CKD MBD
• recombinant GH

Question 5

Chronic Renal Disease

Complication Treatment:

Anemia

Answer 5

EPO

Iron supplementation

Question 6

Chronic Renal Disease

Complication Treatment:

CKD-MBD

/secondary hyperparathyroidism

Answer 6

1.25-Dihydroxyvitamin D supplementation

calcium supplementation

dietary phosphorous restriction

phosphate binders

Question 7

Chronic Renal Disease

Complication Treatment:

Hyperternsion

Left ventricular hypertrophy

Answer 7

Antihypertensive medications

Volume control

Question 8

Chronic Renal Disease

Complication Treatment:

Hyperkalemia

Hyponatremia

Metabolic acidosis

Answer 8

Low K diet, furosemide, sodium polystrene sulfonate

Sodium supplementation

Alkali replacement

Question 9

Classification of the Stages of Chronic Kidney Disease

Answer 9

Unit: GFR (mL/min/1.73m²)

1. >90 Minimal Kidney Damage
2. 60-89 Kidney damage with mild reduction of GFR
3. 30-59 Moderate reduction of GFR
4. 15-29 Severe reduction of GFR
5. <15 (or dialysis) End-stage renal disease