Chronic Kidney Disease Flashcards
Chronic kidney disease (CKD) is defined by the presence of _________ or ———— for ___________, irrespective of the cause.
kidney damage or decreased glomerular filtration rate (GFR)
three or more months
Chronic kidney disease (CKD)
This ________ duration distinguishes chronic from acute kidney disease.
three-month
Chronic kidney disease (CKD)
For patients being evaluated for elevated _________ or reduced _________, it is important to distinguish those who have relatively stable ______ from those who have ________________, which may be ongoing and reversible.
serum creatinine
estimated glomerular filtration rate (eGFR)
CKD
acute or subacute kidney injury
Acute kidney injury (AKI) is defined by a rise in the _________ level that has developed within _____________
serum creatinine
hours to days.
Subacute kidney injury (also called _____________) informally refers to any decline in kidney function that evolves over more than ________ but less than _______
acute kidney disease
48 hours
three months.
CKD patients may present with symptoms and signs resulting directly from diminished kidney function, such as ________ or _______.
edema or hypertension
CKD patients
There may be no clinical symptoms, and kidney disease is often detected in patients when ______________,________________, or ____________ is discovered incidentally.
an elevated serum creatinine, reduced estimated glomerular filtration rate (eGFR), or an abnormal urinalysis
IN CKD patients
Radiographic findings (eg, _____ and _____ kidneys [by ultrasound] suggesting chronic damage, multiple bilateral renal ______ with enlarged kidneys suggestive of _____________) may be observed on imaging performed for some other reason.
small and echogenic
cysts
polycystic kidney disease
Depending upon the duration and severity of CKD, patients may also present with symptoms and/or signs of prolonged kidney failure which includes ______ and easy _______, anorexia, vomiting, pruritus, and, in very advanced stages, with _________ or _________.
weakness
fatigability
encephalopathy or seizures
Azotaemia – Increase in blood concentration of _____________________________
nitrogenous waste products of metabolism
Uraemia – build up of _______ in blood in people with __________
metabolic toxins
kidney failure
Reduced urine output (ie, oliguria or anuria) is often observed with CKD alone
T/F
Oliguria/Anuria may indicate at least some component of ———————
F
Seldom
acute kidney injury (AKI).
Oliguria or anuria may be present among patients with _________________ on ________, such as may be observed in a patient with chronic ________ who develops acute __________.
AKI superimposed on CKD
obstruction
urinary retention
Similarly, anuria as a result of severe or prolonged _____, bilateral ___________ or bilateral ________ (eg, due to a ___________) may occur in patients with underlying CKD.
shock
urinary tract obstruction
renal arterial occlusion
dissecting aortic aneurysm
The most common laboratory findings in patients with CKD include increased ______________ and ___________.
serum creatinine and blood urea nitrogen
Other common laboratory abnormalities that may be part of the clinical picture in CKD include _____, ____phosphatemia, _____kalemia, metabolic ______, ____calcemia, and _______ parathyroid hormone (PTH).
anemia
hyper; hyper; acidosis
hypo
elevated
Urine studies in CKD patients may show ________uria (or ____uria) and/or abnormal _____________ on urine microscopy.
protein
albumin
red or white blood cells
Risk factors for CKD
Long-standing ______ and _____ commonly lead to CKD.
The ______ of disease and the _____ should be determined in such patients.
diabetes and hypertension
duration; degree of control
Risk factors for CKD
Patients should be asked about a history of prior ———— or _________ to determine if it could have contributed to their CKD.
Prior _____, particularly if ______- requiring, may lead to CKD
severe or prolonged acute kidney injury (AKI)
AKI; dialysis
Risk factors for CKD
In addition, the presence of diabetic or hypertensive _______ should be ascertained because patients with _______ have a higher likelihood of having CKD from diabetes and/or hypertension
retinopathy
retinopathy
Risk factors for CKD
_____ failure, _____ failure, ______ disease, recurrent and complicated urinary tract infections, and reduced kidney ____ (eg, _____,_______) should be elicited due to their associations with CKD.
Heart; liver; autoimmune
mass; nephrectomy, renal agenesis
Risk factors for CKD
Inherited disorders, such as ______,______, and ________ kidney diseases, are relatively common causes of CKD.
Thus, it is important to ask specific questions about ______ in family members, including their history of abnormal _______ or abnormal ______
cystic, interstitial, and glomerular
kidney disease
kidney imaging
urine studies
Risk factors for CKD
Patients who have a history of ____ and treatment with _______ may develop CKD from the _____ itself or from ______
cancer
chemotherapy or radiotherapy
cancer; its treatment.
Risk factors for CKD
• Patients with renal cell carcinoma often require a partial or complete ________, which can lead to CKD from _______.
Also, patients who are treated with chemotherapy may develop CKD as _____________________ of their treatment.
nephrectomy
decreased renal mass
an adverse consequence
Risk factors for CKD
Urinary tract obstruction should be suspected among patients who have a history of prior _____ surgery , prior ___________ surgery, a known or suspected _____ or ______ malignancy, _________ disease involving the bladder, gross hematuria, lower abdominal, pelvic, or flank pain, or in men with lower urinary tract symptoms.
urological
pelvic or retroperitoneal
abdominal or retroperitoneal
neurologic