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2nd Year - Urinary Diseases > 3.2. Kidney Injury - Chronic Kidney Disease > Flashcards

3.2. Kidney Injury - Chronic Kidney Disease Flashcards

(42 cards)

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1
Q

What is Chronic Kidney Disease?

A

The irreversible and significant loss of Renal Function

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2
Q

What causes Chronic Kidney Disease?

A

Recurrent bouts of Acute Kidney Injury, causing irreversible damage to the Kidneys Function

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3
Q

What function of the Kidneys is also characteristic of Chronic Kidney Disease?

A

A Glomerulofiltration Rate of less than 60ml/min/1.73m^2 for more than 3 months (90ml/min/1.73m^2 being normal)

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4
Q

What is the main predisposing factor for Chronic Kidney Disease?

A

Age - it is found in 8-12% of the population

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5
Q

What are the 3 classes of contributing factors to Chronic Kidney Disease?

A
  1. Pre-Renal
  2. Renal
  3. Post-Renal
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6
Q

What is included in the Pre-Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. Renovascular Disease causing Ischemic Nephropathy
  2. Persistently decreased Renal Perfusion
  3. Hypertension
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7
Q

What is included in the Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. Diabetic Nephropathy
  2. Polycystic Kidney Disease
  3. Glomerulonephritis
  4. Chronic Nephrotoxin Exposure
  5. Rare Causes
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8
Q

What is included in the Post-Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. Reflux Nephropathy and Scarring

2. Chronic Obstructive Nephropathy

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9
Q

What are some examples of Nephrotoxins, which can lead to Chronic Nephrotoxin Exposure, in the Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. NSAID’s
  2. Lithium
  3. Lead
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10
Q

What are some examples of Rare Causes, which can lead to Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. Myelome
  2. Sarcoidosis
  3. Nephrocalcinosis
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11
Q

What are some examples of Chronic Obstructive Nephropathy, in the Post-Renal Class of contributing factors to Chronic Kidney Disease?

A
  1. Prostatic Disease
  2. Metastatic Cancer
  3. Pelvi-Ureteric Junction Obstruction
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12
Q

What are the Clinical Features of Chronic Kidney Disease?

A
  1. Loss of Glomerular Filtration
  2. Loss of Tubule Function
  3. Retention of Urea
  4. Retention of Creatinine
  5. Oliguria
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13
Q

What investigations are necessary for Chronic Kidney Disease?

A
  1. Detailed History / Examination
  2. Blood Tests
  3. Urinalysis (Urine Dipstick)
  4. Renal Radiography
  5. Renal Biopsy
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14
Q

What can be determined by a detailed history / examination?

A
  1. Previous Renal Disease
  2. Drug Exposure
  3. Ensure the vitals are non-life threatening
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15
Q

What blood tests will be done?

A
  1. Serum Creatinine
  2. Urea and Electrolytes including Bicarbonate, Immunoglobulins, Total Protein etc.
  3. Full Blood Count
  4. Coagulation Screen
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16
Q

What is the purpose of testing for a Serum Creatinine?

A

To assess the secretory function of the Kidney / Glomerular Filtration Rate (GFR)

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17
Q

What will be looked for in the Urinalysis (Urine Dipstick)?

Study These Flashcards
A
  1. Haematuira

2. Proteinuria (including Protein-Creatinine ratio, and the Albumin-Creatinine ratio)

18
Q

What is included in the Renal Radiography?

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A
  1. Ultrasound
  2. CT Scan
  3. MRI Scan
19
Q

Why is a Renal Biopsy done?

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A

To assess the anatomical / structural damage

20
Q

When should Glomerulonephritis be tested for?

Study These Flashcards
A

When there is a clinical suspicion that this could be contributing to the Chronic Kidney Disease

21
Q

How many stages are there in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?

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A

6 (1., 2, 3a, 3b, 4, 5)

22
Q

What is the description of “Stage 1” disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?

Study These Flashcards
A

Kidney Damage / Normal or High Glomerular Filtration Rate (Greater than 90 ml/min/1.73m^2)

23
Q

What is the description of “Stage 2” disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?

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A

Kidney Damage / Mild reduction in Glomerular Filtration Rate (Between 60-90 ml/min/1.73m^2)

24
Q

What is the description of “Stage 3a” disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?

Study These Flashcards
A

Moderately Impaired Kidney

A Glomerular Filtration Rate of 45 - 59 ml/min/1.73m^2

25
What is the description of "Stage 3b" disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?
Moderately Impaired Kidney | A Glomerular Filtration Rate of 30 - 44 ml/min/1.73m^2
26
What is the description of "Stage 4" disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?
Severely Impaired Kidney | A Glomerular Filtration Rate of 15 - 29ml/min/1.73m^2
27
What is the description of "Stage 5" disease, in the KDIGO (Kidney Disease; Improving Global Outcomes) classification of Chronic Kidney Disease?
Advanced Kidney Impairment or on Dialysis | A Glomerular Filtration Rate of Less than 15ml/min/1.73m^2
28
What are the 2 types of treatment?
1. Slow the Rate of Renal Decline 2. Prevent / Control Complications 3. Renal Replacement Therapy
29
What is included in the Slowing the Rate of Renal Decline part of treatment?
1. Treating the Underlying Aetiology 2. Blood Pressure control with Anti-hypertensive Medication 3. Proteinuria control with ACE inhibitors / ARB's
30
What KDIGO Stage do you tend to be in before you experience complications?
4
31
What is a way to help you remember the complications of Chronic Kidney Disease?
A, A, B, C, D, E, F, G, H, I | A, A-I
32
What complications can occur?
``` Acidosis Anaemia Bone Disease Cardiovascular Risk Dialysis / Death Electrolyte Dysfunction Fluid Overload Gout Hypertension Iatrogenic Issues ```
33
How is the Acidosis Complication treated?
With Oral Sodium Bicarbonate
34
How is the Anaemia Complication treated?
With Iron Erythropoietin Replacement
35
How is the Bone Disease Complication treated?
1. Diet 2. Phosphate Binders 3. Vitamin D Analogues
36
How is the Cardiovascular Risk Complication treated?
1. Blood Pressure Control 2. Aspirin 3. Statins 4. Cholesterol Management 5. Weight change
37
How is the Dialysis Complication treated?
Counsel and Prepare
38
How is the Electrolyte Dysfunction Complication treated?
The Hyperkalaemia is treated with Diet and potentially with Drugs
39
How is the Fluid Overload Complication treated?
1. Sodium Restriction | 2. Fluid Restriction
40
How is the Gout Complication treated?
Optimize +/- medication
41
How is the Hypertension Complication treated?
1. Weight 2. Diet 3. Fluid Balance 4. ACE inhibitors 5. Other Anti-hypertensives
42
How is the Iatrogenic Complication treated?
Nephrotoxic Medication Cessation

2nd Year - Urinary Diseases (16 decks)

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