Chronic kidney disease

Question 1

CKD Causes
diabetic […]
chronic […]
chronic […]
[…]
adult […] […] […]

Answer 1

diabetic nephropathy
chronic glomerulonephritis
chronic pyelonephritis
hypertension
adult polycystic kidney disease

Question 2

Late features
[…]: e.g. ankle swelling, weight gain
[…]
[…]
pruritus (secondary to […])
anorexia, which may result in weight […]
insomnia
nausea and vomiting
hypertension

Answer 2

oedema: e.g. ankle swelling, weight gain
polyuria
lethargy
pruritus (secondary to uraemia)
anorexia, which may result in weight loss
insomnia
nausea and vomiting
hypertension

Question 3

Anithypertensive in CKD, esp when GFR<45

Answer 3

Furosemide

Question 4

CKD and bone disease - renal […]
low vitamin […] (1-alpha hydroxylation normally occurs in the kidneys)
high […]
low […]: due to lack of vitamin D, high phosphate
[…] […]: due to low calcium, high phosphate and low vitamin D

Answer 4

Renal osteodystrophy
low vitamin D (1-alpha hydroxylation normally occurs in the kidneys)
high phosphate
low calcium: due to lack of vitamin D, high phosphate
secondary hyperparathyroidism: due to low calcium, high phosphate and low vitamin D

Question 5

Complications of renal osteodystrophy

Answer 5

Osteoporosis
Osteosclerosis
Osteitis fibrosa cystica
Brown tumour

Question 6

If ACR >3 - kidney disease
If ACR>70 - refer to […]

Answer 6

If ACR >3 - kidney disease
If ACR>70 - refer to nephrologist

Question 7

If normal BP but ACR>70

Answer 7

ACEi

Question 8

Management of CKD: bone mineral disease

Answer 8

Reduce Phosphate intake
Vit D
Phosphate binders

Question 9

Variables of MDRD

Answer 9

Serum creatinine
Age
Gender
Ethnicity

Question 10

If stage 5 CKD, management?

Answer 10

Transplant or dialysis

Question 11

CKD and anaemia

Answer 11

Reduced EPO
Normochromic normocytic anaemia

Question 12

Management of reduced EPO in CKD

Answer 12

Target 10-12Hb
Optimise Hb before giving EPO eg. give iron tablets or IV iron if tablets not worked in 3 months