6b. Kidney disease

Question 1

Question 2

What are the functions of the kidney?

Answer 2

Question 3

Link between kidneys and calcium metabolism?
Where do we get vitamin D from?

Answer 3

Question 4

How are kidneys involved with blood pressure?

Answer 4

Question 5

What is chronic kidney disease?
What does GFR stand for?
What is the normal GFR.

Answer 5

Question 6

causes of chronic kidney disease?

Answer 6

Question 7

Effects of chronic kidney disease

Answer 7

Question 8

What is dialysis?
What are the types of dialysis?

Answer 8

EXTRA
- CAPD
- patients who use are at risk of developing spontaneous bacterial peritonitis = life threatening condition
- hence used less
- used less frequently than haemodilaysis
- usu used for younger patients who are busier in life so they don’t have to regularly attend dialysis units

Question 9

What does this diagram show

Answer 9

Question 10

What does this diagram show

Answer 10

Question 11

• fistula

Question 12

fistula cannulated + linked up to dialysis machine

Question 13

Renal transplant

Answer 13

• diff renal surgeons have diff opinions on AB cover so useful to ask physician for advice if AB cover is needed + if so, what one + what dose

Question 14

Dental aspects of kidney disease

Answer 14

• due to heparin, safest time to treat patient on dialysis = an alternate dialysis day = day in between their dialysis sessions
• because effects of dialysis will be at maximum but the heparin would have worn off

Question 15

What can you prescribe for a patient with kidney disease?

Answer 15

• lots of drug dosage needs to be lowered
• helpful to check BNF to guide you on how to prescribe these patients

Question 16

What are the blood tests needed for kidney disease ?

Answer 16

Question 17

Interpreting UandEs

What are the grades of chronic kidney disease ?

Answer 17

• ESFR = end stage renal failure

Question 18

What does this show

Answer 18

Question 19

What does this show

Answer 19

Question 20

What does this show

Answer 20

• just because patient has had renal transplant doesn’t mean renal function will be back to normal
• should not give these patients NSAIDs or you’ll be damaging the transplanted kidney

Question 21

What does this show

Answer 21

• shows how kidney function is affected by advancing age
• this is a pretty normal level of renal impairment of a patient of this age, who is otherwise completely healthy

Question 22

TIP

Answer 22

need to be particularly cautious with patients who:
- are elderly
- have hypertension
- have diabetes
- or any combo of those 3

BECAUSE
* may not give history of renal impairment but those factors increase the risk so we should take it into consideration + assume they have some degree of renal impairment + take that into consideration when prescribing (in particular avoiding NSAIDs and prescribing paracetamol instead)