Chronic Kidney Disease Flashcards
Which two chemicals associated in acid base homeostasis in kidneys
H+
Bicarbonate
Which endocrine things does function of kidney affect
Erythropoetin
Vitamin D Metabolism
Renin
How do you measure excretory renal function
Insulin Clearance
Isotope GFR
24 Hour Urine Collection
Blood Test
Creatinine will not be raised above normal range in Chronic Kidney Disease until
60% of Total Kidney Function Lost
What is Creatinine generated from
Breakdown of Muscle
CKD Stage 1
Kidney Damage/Normal or High GFR >90
CKD Stage 2
Kidney Damage/Mild Reduction in GFR 60-89
CKD Stage 3a
Mod Impaired 45-59 GFR
CKD Stage 3b
Mod Impaired 30-44 GFR
CKD Stage 4
Severe Impaired 15-29 GFR
CKD Stage 5
Advanced or on Dialysis <15 GFR
How to assess for kidney disease
Filtration Function: Estimates of EGFR from creatinine blood test
What crosses GBM
Water
Electrolytes
Urea
Creatinine
What crosses GBM but is reabsorbed in Prox Tubule
Glucose
Microglobulin
What does not cross GBM
Cells (RBC, WBC)
Albumin
Globulins
When assessing filtering function should any blood or protein be measurable if urine filtering properly?
No
How to protein quantify?
Protein creatinine ratio
CKD Definition
either the presence of kidney damage (abnormal blood, urine or x-ray findings) or GFR<60 ml/min/1.73m2 that is present for ≥3 months
Aetiology of CKD
Diabetes Glomerulonephritis Hypertension Renovascular Disease Polycystic Kidney Disease
Symptoms and Signs of CKD
Hypertension Breathless Itch and Cramps Cognitive Changes Polyuria Oliguria Nocturia Haematuria Proteinuria Peripheral Oedema
why does peripheral oedema happen
renal sodium retention
How to slow rate of renal decline
BP Control
Control Proteinuria
How to control Proteinuria in CKD
Ace Inhibitors/ARBS
CKD Complications
Anaemia Hypertension 25 (OH) Vit D Deficiency Acidosis Hyperphosphatemia Hypoalbuminaemia Hyperparathyrodism
How to Manage Acidosis in CKD
Bicarb
How to Manage Fluid Overload in CKD
Diuresis
