chronic kidney disease Flashcards
what is chronic kidney disease?
-reduction in kidney function OR -structural damage OR -both
AND
-present for more than 3 months
WITH
-associated health implications
who should CKD be diagnosed in?
-people with ‘markers of kidney damage’
THE ASS
- Transplant (anyone with a kidney transplantation)
- Histological (abnormalities detected in kidney biopsy)
- Electrolyte (abnormalities due to tubular disorder)
- ACR (urine albumin: creatinine ratio greater than 3mg/mmol)
- Sediment (abnormalities in urine such as haematuria and casts)
- Structural (abnormalities detected by imaging)
and/or
-a persistent reduction in renal function shown by a serum estimated glomerular filtration rate (eGFR) of less than 60mL/min/1.73m3
what are the stages of CKD?
how often do patients need reviewed depending on their stage of CKD?
what is classed as ‘accelerated progression’ of CKD?
-a persistent decrease in eGFR of 25% or more
AND
-a change in CKD category within 12 months
OR
-a persistent decrease in eGFR of 15mL/min/1.73m2 within 12 months
what are most common causes of CKD?
- diabetes (44%)
- high blood pressure (29%)
- other AKI, nephrotic drugs, SLE, GPA, MPA, EGPA, myeloma or obstructive uropathy
- Polycystic kidney disease (1.6%)
- Glomerular (7%)
what are examples of nephrotic drugs?
what systemic diseases can cause CKD?
SLE, GPA, MPA, EGPA, myeloma
what are some complications of CKD?
- CVD
- AKI
- hypertension
- dyslipidaemia
- renal anaemia
- renal and mineral disorders
- peripheral neuropathy and myopathy
- malnutrition
- malignancy
- end stage renal failure
- mortality
when should you not modify ACEI and ARB dose?
-if eGFR decrease from pre treatment baseline is less than 25%
OR
-serum creatinine increase from baseline is less than 30%
who is more at risk of renal anemia?
diabetics
when is renal anaemia less common in?
eGFR >45 (CKD 3a and above)
what is target Hb in someone with renal anaemia?
Hb 100-120g/L
