Chronic Kidney Disease

Question 1

Define chronic kidney disease

Answer 1

Gradual, irreversible decline in kidney function. Decreased GFR or markers of kidney damage for >3 months

Question 2

Symptoms of CKD

Answer 2

Usually asymptomatic until stage 4 or 5 due to compensatory mechanisms

Question 3

Stage 1 CKD

Answer 3

eGFR >90ml/min/1.73m2 with signs of kidney damage (proteinuria, haematuria)

Question 4

Stage 2 CKD

Answer 4

eGFR 60-89ml/min/1.73m2 with signs of kidney damage (raised albumin:creatinine)

Question 5

Stage 3 CKD

Answer 5

eGFR 30-59ml/min/1.73m2 with signs of kidney damage

Question 6

Stage 4 CKD

Answer 6

eGFR 15-30ml/min/1.73m2 with signs of kidney damage

Question 7

Stage 5 CKD

Answer 7

eGFR <15ml/min/1.73m2 with signs of kidney damage

Question 8

Most common causes of CKD

Answer 8

Diabetes, HTN, chronic glomerulonephritis and PCKD

Question 9

Less common causes of CKD

Answer 9

Glomerular causes, vascular causes, tubulointerstitial causes, congenital and developmental

Question 10

Glomerular causes of CKD

Answer 10

IgA nephropathy, SLE

Question 11

Vacular causes of CKD

Answer 11

Vasculitis, renal artery stenosis

Question 12

Tubulointerstitial causes of CKD

Answer 12

Myeloma, amyloidosis

Question 13

Congenital causes of CDK

Answer 13

Alport syndrome, PCKD

Question 14

Developmental causes of CKD

Answer 14

Chronic pyelonephritis

Question 15

What does failure of the kidney to excrete waste cause

Answer 15

Uraemia and hyperphosphataemia

Question 16

What does failure to regulate acid-base balance cause

Answer 16

Metabolic acidosis

Question 17

What does failure of kidney to produce erythropoiten cause

Answer 17

Anaemia

Question 18

What does failure to regulate fluid balance cause

Answer 18

Hypertension and pulmonary oedema

Question 19

What does the failure of kidney to activate vitamin D cause

Answer 19

Hypercalcaemia

Question 20

Complications of chronic kidney disease

Answer 20

CVD
Renal osteodystrophy
Fluid (oedema)
Hypertension
Anaemia
Electrolyte disturbances
Leg restlessness
Sensory neuropathy

Question 21

Features of renal osteodystrophy

Answer 21

Osteoporosis, osteomalacia, secondary/tertiary hyperparathyroidism, spinal osterosclerosis

Question 22

What is spinal osterosclerosis also known as

Answer 22

Rugger Jersey Spine

Question 23

Ways to slow the progression of CKD and its complications

Answer 23

Optismise risk factors - BP control, stop smoking, diabetes control, healthy weight and diet, exercise

Question 24

Electrolyte disturbances caused by CKD

Answer 24

Hyperkalaemia, acidosis and hyperphosphataemia

Question 25

How to treat renal acidosis complication

Answer 25

Sodium bicarbonate

Question 26

How to treat anaemia caused by CKD

Answer 26

Monthly SC erythropoietin injections

Question 27

How to treat oedema caused by CKD

Answer 27

Fluid and salt restriction and use diuretics such as furosemide

Question 28

Ways to treat hypercalcaemia and hyperphosphataemia

Answer 28

Vitamin D for mineral bone disease, restrict dietary K+, prescribe K+ binder sevelamer, prescribe Vit D analogue alfacalcidiol.