Chronic Kidney Disease Flashcards
Define chronic kidney disease
Gradual, irreversible decline in kidney function. Decreased GFR or markers of kidney damage for >3 months
Symptoms of CKD
Usually asymptomatic until stage 4 or 5 due to compensatory mechanisms
Stage 1 CKD
eGFR >90ml/min/1.73m2 with signs of kidney damage (proteinuria, haematuria)
Stage 2 CKD
eGFR 60-89ml/min/1.73m2 with signs of kidney damage (raised albumin:creatinine)
Stage 3 CKD
eGFR 30-59ml/min/1.73m2 with signs of kidney damage
Stage 4 CKD
eGFR 15-30ml/min/1.73m2 with signs of kidney damage
Stage 5 CKD
eGFR <15ml/min/1.73m2 with signs of kidney damage
Most common causes of CKD
Diabetes, HTN, chronic glomerulonephritis and PCKD
Less common causes of CKD
Glomerular causes, vascular causes, tubulointerstitial causes, congenital and developmental
Glomerular causes of CKD
IgA nephropathy, SLE
Vacular causes of CKD
Vasculitis, renal artery stenosis
Tubulointerstitial causes of CKD
Myeloma, amyloidosis
Congenital causes of CDK
Alport syndrome, PCKD
Developmental causes of CKD
Chronic pyelonephritis
What does failure of the kidney to excrete waste cause
Uraemia and hyperphosphataemia
What does failure to regulate acid-base balance cause
Metabolic acidosis
What does failure of kidney to produce erythropoiten cause
Anaemia
What does failure to regulate fluid balance cause
Hypertension and pulmonary oedema
What does the failure of kidney to activate vitamin D cause
Hypercalcaemia
Complications of chronic kidney disease
CVD
Renal osteodystrophy
Fluid (oedema)
Hypertension
Anaemia
Electrolyte disturbances
Leg restlessness
Sensory neuropathy
Features of renal osteodystrophy
Osteoporosis, osteomalacia, secondary/tertiary hyperparathyroidism, spinal osterosclerosis
What is spinal osterosclerosis also known as
Rugger Jersey Spine
Ways to slow the progression of CKD and its complications
Optismise risk factors - BP control, stop smoking, diabetes control, healthy weight and diet, exercise
Electrolyte disturbances caused by CKD
Hyperkalaemia, acidosis and hyperphosphataemia
How to treat renal acidosis complication
Sodium bicarbonate
How to treat anaemia caused by CKD
Monthly SC erythropoietin injections
How to treat oedema caused by CKD
Fluid and salt restriction and use diuretics such as furosemide
Ways to treat hypercalcaemia and hyperphosphataemia
Vitamin D for mineral bone disease, restrict dietary K+, prescribe K+ binder sevelamer, prescribe Vit D analogue alfacalcidiol.