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Y3 Renal Conditions > Chronic kidney disease > Flashcards

Chronic kidney disease Flashcards

1
Q

Describe the chronic decline in kidney function in CKD

A
  • progressive

- permanent

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2
Q

Key difference between underlying cause of AKI vs CKD

A

CKD is caused by chronic co-morbidities

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3
Q

Examples of causes of CKD (just to be aware of)

A
  • DM
  • hypertension
  • age-related decline
  • glomerulonephritis
  • PKD
  • NSAIDs/PPIs/lithium
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4
Q

RFs for CKD

A

Same as AKI

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5
Q

When CKD is symptomatic it can have the following features

A
  • purities
  • loss of appetite
  • nausea
  • oedema
  • muscle cramps
  • peripheral neuropathy
  • pallor
  • hypertension
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6
Q

How far apart should the 2 U&Es tests for CKD be to determine impaired eGFR

A

3 months apart

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7
Q

How is haematuria detected

A

Blood in urine dipsticks

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8
Q

Indications for renal USS

A
  • accelerated CKD
  • haematuria
  • FH
  • PKD
  • obstruction
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9
Q

What G score and A score are needed for a CKD diagnosis

A

G3a

A2

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10
Q

G3a (based of eGFR) is

A

45-59

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11
Q

A2 (based on ACR) is

A

3-30

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12
Q

CKD patient should be referred to a specialist if eGFR is

A

<30

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13
Q

CKD patient should be referred to a specialist if ACR is

A

> 70

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14
Q

CKD patient should be referred to a specialist if eGFR decreases by …. in a year which is a sign of a rapidly progressing CKD

A

25% (15ml/min)

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15
Q

CKD patient should referred to a specialist if their hptn is still uncontrolled despite being on how many antihypertensives

A

4

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16
Q

How to slow the progression of CKD

A
  • optimise diabetic/hypertensive control

- treat glumerulonephritis

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17
Q

How to reduce risk of CKD complications

A
  • healthy lifestyle

- atrovastatin

18
Q

Oral medication given to Tx metabolic acidosis due to CKD

A

Na2CO3

19
Q

2 components to treat anaemia due to CKD

A
  • iron supplements

- erythropoietin

20
Q

Vitamin given to treat renal bone disease due to CKD

A

VitD

21
Q

End stage RF can be treated with one of the following

A
  • dialysis

- renal transplant

22
Q

Why does CKD lead to anaemia

A

— erythropoietin —> — RBCs

23
Q

1st line to correct iron deficiency prior to EPO Tx

A

IV Fe

24
Q

2nd line to correct iron deficiency prior to EPO Tx

A

PO Fe

25
Q

Why should blood transfusions to correct anaemia in CKD be limited

A

Avoid allosensitisation

26
Q

Diabetic patients with an ACR of …. should be offered ACEi

A

> 30mg/mmol

27
Q

Hypertensive patients with an ACR of …. should be offered ACEi

A

> 30mg/mmol

28
Q

Any patient with ACR of …. should be offered ACEi

A

70mg/mmol

29
Q

Why should serum K be monitored in CKD patients on ACEi

A

CKD + ACEi —> ++ serum K

30
Q

Features of rugger spine on XR of CKD-MBD

A
  • sclerosis of end of Vs

- osteomalacia in centre of Vs

31
Q

Why is there an elavated serum PO4 in CKD-MBD

A

— PO4 excretion

32
Q

Why is there low active VitD in CKD-MBD patients

A

Kidneys activate VitD

33
Q

Why is there — Ca absorption in CKD-MBD

A

— PO4 & — VitD

34
Q

Explain the 2ry hyperPTHism in CKD-MBD

A

— Ca

35
Q

Explain the osteomalacia in CKD-MBD

A

— Ca —> ++ osteoclast activity —> + bone turnover with insufficient Ca

36
Q

Explain the osteosclerosis in CKD-MBD

A

+ osteoblast activity (to match osteoclast activity) —> poorly formed tissue (inadequate Ca supply)

37
Q

RFs for osteoporosis

A
  • age

- steroids

38
Q

VitD options to correct osteomalacia

A
  • alfacalcidol

- calcitriol

39
Q

Tx for osteoporosis

A

Bisphosphonates

40
Q

Substance to lower in diet to reduce risk of bone issues

A

PO4 (since prime is PO4 excretion)

Y3 Renal Conditions (9 decks)

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