Chronic Kidney Disease (0) Flashcards
What is chronic kidney disease?
Chronic reduction in kidney function as a result of damage to the kidneys, their vessels or pathology within lower urinary tract
Definition of CKD?
Impaired function: excretion of waste, salt water and acid base homeostasis and endocrine activity
Clinical definition of CKD?
- Reduction in GFR to <60 mL/min for atleast 3 months or
- Persistent proteinuria/haematuria
Causes of CKD?
- Diabetes
- HT
- Age related decline
- Glomerulonephritis
- PCKD
- Medications: NSAIDs, PPI, Ciclosporin, lithium
- SLE
Risk factors for CKD?
- Older
- HT
- Diabetes
- Smoking
- Use of kidney affecting meds
- African -Carribean or south Asian more likely
- AKI
- Hereditary
- Genetics
- Renal tract infections
Presnetation of CKD?
-Uually symptomatic and diagnosed on routine testing Signs: -Pruritus -Loss of appetite -Nausea -Oedema -Muscle cramps -peripheral neuropathy -Pallor -HT
Complications of CKD?
- Anaemia
- Renal bone disease
- CVS
- Peripheral neuropathy
- Dialysis related problem
Investigation of CKD?
- Estimated glomerular filtration rate (eGFR) using U&E blood test
- Proteinuria checked using urine albumin:creatinine ratio
- Haematuria: urine dipstick
- Renal US
- Proteinuria in patient with diabetes
- Urine microscopy
- Urine electrolytes
- Urine protein electrophoresis
- Urinary Bence Jones protein
- FBC
Detail about eGFR test for CKD?
2 tests 3 months apart to diagnose
Result of what is significant in albumin:creatinine ratio?
> 3 mg/mmol
Significant result in urine dipstick?
1+ of blood
Diagnosing CKD?
Use acronym THE ASS
- Transplant
- Histological abnormalities
- Electrolyte abnormalities
- ACR >3mg/mmol
- Sediment abnormalities in urine
- Structural abnormalities
Staging of CKD?
G1: eGFR >90 G2: eGFR = 60-89 G3a: eGFR= 45-59 G3b: eGFR = 30-44 G4: eGFR= 15-29 G5: eGFR <15
Scoring of albumin: creatinine ratio?
A1: <3mg/mmol
A2: 3-30mh/mmol
A3: >30mg/mmol
Patient doesn’t have KD if they have what score?
A1 combined with G1/2
