Chronic Kidney Disease Flashcards
what is CKD
reduction in kidney function or structure or both present for >3months
stages of CKD
GFR- G1-G5, ACR- A1-A3
G5= GFR <15
ACR: A1= <3, A3= >30
what is accelerated progression CKD
persistent dec in eGFR of 25% and change in CKD category within 12 months
aetiology of CKD
intrinsic kidney damage- HT, DM AKI bouts nephrotoxic drugs obstructive uropathy: calculi multisystem: SLE, vasculitis CVD obesity
some nephrotoxic drugs?
amionglycosides, ACEI/ARBs, bisphosphonates, calcineurin inhibitors, diuretics, lithium, mesalazine, NSAIDs
s/s of chronic renal disease
thirst, loss of interest in food, vitamin imbalance, malnutrition, anaemia
ix for CKD
urinary albumin: Cr ratio urinary sediment abnormalities electrolyte imbalance histology imaging
mx for CKD
lifestyle: fluid restirocton, K+ restriction
RRT: ESRD
treat underlying condition
what are 2 complications of CKD
renal anaemia: due to reduced production of erythropoietin by kidney, diabetes inc risk, tiredness, fatigue. mx- iron supplements
renal mineral and bone disorder: bone pain/fragility due to disturbed VitD, Ca, PTH and phosphate metabolism
glomerulonephritis is…
immune mediated disease of the kidneys affecting glomeruli with 2y tubulointerstitial damage. chronic Gn is most common cause of ESRD
what are the 2 histologic types of Gn
damage to endothelial or mesangial cells- proliferative lesion- RBCs in urine
damage to podocytes- non-proliferative lesion- protein in urine
what does it mean if lesion is crescentic
presence of crescents ie. epithelial cell extra-capillary proliferation
types of Gn
1y idiopathic:
- minimal change
- FSGS
- Membranous
- Membranoproliferative
- IgA nephropathy
2y
minmal change Gn…
commonest Gn in kids, non progressive renal failure
oral steroids
FSGS Gn..
commonest cause of nephrotic syndrome in adults, oral steroids (50% progress to ESRF after 10yrs)