Chronic Kidney Disease Flashcards
What is CKD?
Chronic reduction in kidney function
Permanent and progressive
What is the diagnostic definition of CKD?
eGFR<60 or the presence of kidney damage for >3 months
What are the causes of CKD?
Diabetes
Hypertension
Age-related decline
Glomerulonephritis
Polycystic kidney disease
Medications such as NSAIDS and PPI’s
Systemic diseases
How does CKD usually present?
Usually asymptomatic and diagnosed on routine testing
What are signs and symptoms of CKD?
Pruritis
Loss of appetite
Nausea
Oedema
Muscle cramps
Peripheral neuropathy
Pallor
HTN
What investigations are carried out for CKD?
eGFR- uses creatinine
ACR or PCR- proteinuria
Urine dipstick- haematuria
Renal biopsy- histology
Renal ultrasound
What are the staging scores for CKD?
G score- eGFR
A score- albumin: creatinine ratio
What are the stages of the G score?
G1= eGFR>90
G2= eGFR 60-89
G3a= eGFR 45-59
G3b= eGFR 30-44
G4= eGFR 15-29
G5= eGFR<15 (kidney failure)
What are the stages of the A score?
A1= <3mg/mmol
A2= 3-30mg/mmol
A3= >30mg/mmol
What are the complications of CKD?
Acidosis
Anaemia
Renal bone disease
CVD
Dialysis related problems
Fluid overload
Hypertension
What are the aims of CKD treatment?
Slow progression of the disease
Reduce risk of complications
Treat complications
How do you slow CKD progression?
Control diabetes
Control hypertension
Treat glomerulonephritis
How do you reduce risk of complications?
Exercise
Stop smoking
Diet
Atorvastatin- prevent CVD
How do you treat complications?
Acidosis- bicarb
Anaemia- iron
Renal bone diseases- phosphate binders, Vitamin D
CVD- BP control, aspiring, weight loss
Dialysis- counselling, renal transplant
Fluid overload- salt and fluid restriction, diuretics
Hypertension- weight loss, drugs (ACEIs)
