chronic kdney disease 4/22 Flashcards
What is chronic Kidney disease?
Loss of nephron function. Think about losing nephrons
Physical signs?
hypertension, edema, flank masses (rare)
Lab data in CKD?
serum creatinine, BUN
Imaging in CKD
Kidney ultrasound SMALL SHRUNKEN KIDNEYS!!!!
What factors favor CKD over acute Kidney disease?
Chronic is most commonly asymptomatic, looka t old urinalysis, peripheral neuropathy, bone problems consistent with hyperparathyroidism, small kidneys, wxy casts
Uremia is what and is a sign of what?
describes the constellation of signs and symptoms associated with advanced renal failure. 100% fatal. It will not stop/
What is the most common etiology of advanced kidney disease in the US?
Diabetes Mellitus
Two broad mechanisms of nephron injury?
Disease Dependent vs Disease Independent
What is the renal response to nephron loss
1) Glomerular hypertrophy
2) Glomerular hyperfiltration- neighboring nephons inc their load
Management of hypertension is accomplished how>
anti-hypertensive meds, sodium restriction. Hypertension will lead to dialysis so you must keep it down.
What are the most common anti-hypertensives?
ACE (angiotensin converting enzyme inhibitors) and ARBs (angiotensin receptor blockers).
What are the early clinical signs of diabetic nephropathy?
Microalbuminuria due to hyperfiltration. This leads to overt proteinuria over time and reduced GFR,Serum creatinine levels double(low GFR), hypertension, death.
Why do you see hyperparathyroidism in CKD?
its trying to maintain calcium and phosphorus balance.
Creatinine creation in the body is entirely dependent on what?
muscle mass
So if you have CKD, and your muscle mass is the same, your creatinine will go up but your creation and excretion will be exactly the same?
Yes
