Chronic Kidney Disease Flashcards
define chronic renal failure and end stage renal disease
CKD is defined as either kidney damage or a GFR less than 60 mL/min/1.73 m 9squared) for 3 months or longer
End-stage renal disease, also called end-stage kidney disease or kidney failure, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys no longer work as they should to meet your body’s needs.
What is the difference between CKD and ESRD?
There are five stages of kidney disease. The difference between CKD Stage 5 and ESRD is the dependence on dialysis. A patient with CKD Stage 5 may or may not be on dialysis and the damage to the kidney may be reversible. A patient with the diagnosis of ESRD requires chronic dialysis.
list risk factors for chronic renal disease
what are the main two??
Diabetes. High blood pressure. Heart (cardiovascular) disease. Smoking. Obesity. Being Black, Native American or Asian American. Family history of kidney disease. Abnormal kidney structure.
Hypertension and Diabetes are two main causes of chronic renal disease.
explain stages of chronic kidney disease according to nephron loss and GFR
Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m 2)
Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m 2)
Stage 3a: Moderate reduction in GFR (45-59 mL/min/1.73 m 2)
Stage 3b: Moderate reduction in GFR (30-44 mL/min/1.73 m 2)
Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m 2)
Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m 2 or dialysis)
nephron loss progressively gets worse.
what factors affect GFR and what other formulas are used to assess GFR?
factors affecting GFR include: age, sex, ethnicity and body size.
formulas used to assess GFR are the Cockroft and Gault or Modification of Diet in Renal Diseases equations.
why does albuminuria clearly indicate kidney damage?
it results from hypertension or diabetes mellitus and occurs when kidneys are damaged.
Protein should not be in the urine as much as it would be in albuminuria. Too much protein if you can find albumin in the urine.
describe mechanisms and manifestations of CKD (figure 34.4)
sodium and water balance: hypertension—> HF, also increased vascular volume—>edema
potassium balance: hyperkalemia
elimination of nitrogenous wastes: uremia, impaired immune function, skin disorders, GI manifestations, neuro manifestations, sexual dysfunction
EPO production: anemia
Acid-Base balance: acidosis, skeletal buffering
activation of vitamin D: osteodystrophies, hypocalcemia
phosphate elimination: hyperparathyroidism
define uremia and outline symptoms
uremia is urine in the blood literally, but it is bloody urine.
The symptoms are: sx/sx of altered fluid, electrolyte, and acid-base balance alterations in regulatory functions.
at the onset, more subtle: weakness fatigue, nausea, apathy
more severe symptoms are: extreme weakness, lethargy, confusion, and frequent vomiting.
what measures are used to slow progression of CKD?
UTIs treated ASAP meds with renal damaging potential should be eliminated blood pressure control intense glycemic control--diabetes no smoking
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describe differences between hemodialysis and peritoneal dialysis
hemodialysis: blood moves from and artery through the tubing and blood chamber in the dialysis machine and then back into the body through a vein.
peritoneal dialysis: a catheter is surgically implanted in the peritoneal cavity below the belly button to give access. The dialysis process involves injecting a sterile dialyzing solution through the catheter over a period of approximately 10 mins. The solution remains in the cavity for a prescribed amount of time, and it is drained out by gravity into a sterile bag.
