Chronic Kidney Disease (1)

Question 1

What is it?

What are its causes?

Answer 1

➊ Gradual, irreversible decline in kidney function, characterised by decreased GFR (< 60) or markers of kidney damage (albuminuria, electrolyte abnormalities, structural or histological renal abnormalities) present for 3 + months

➋ • Diabetes
• Hypertension
• Chronic glomerulonephritis
• Polycystic kidney disease
• Renal artery stenosis
• Amyloidosis, myeloma

Question 2

How is it staged?

Answer 2

• Stage 1 - eGFR is > 90 with demonstrable kidney damage
• Stage 2 - eGFR is 60-89 with demonstrable kidney damage
• Stage 3 - eGFR is 30-60 - CKD diagnosis from here
• Stage 4 - eGFR is 15-30
• Stage 5 - eGFR is < 15 - End-stage renal failure

Question 3

What are its complications?

Answer 3

• CVD
• HTN
• Anaemia (low EPO)
• Electrolyte imbalance (metabolic acidosis, hyperkalaemia)
• Renal bone disease
• Peripheral/pulmonary oedema
• Peripheral neuropathy

N.B. CVD is the most common cause of death in those with CKD

Question 4

How is it managed?

Answer 4

• Control DM
• Control HTN - ACEi 1st line
• Iron supplementation and EPO for anaemia
• Salt restriction and diuretics for oedema
• Vit D for renal bone disease
• Sodium Bicarbonate for metabolic acidosis