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Year 2- Urinary > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

What are the functions of the kidneys?

A

Body fluid homeostasis
Regulation of vascular flow
Excretory flow
Electrolyse homeostasis
Acid-base homeostasis
Endocrine function

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2
Q

Can glomerular filtration rate (GFR) be measured directly?

A

No

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3
Q

How can excretory renal function be measured?

A

Measure a substance in the blood that is only cleared by the kidneys e.g. serum creatinine

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4
Q

However, at which % of normal GFR does creatinine levels start to rise?

A

50% approx of normal GFR

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5
Q

How is creatinine generated?

A

Breakdown of muscle

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6
Q

What classification system in used to classify excretory kidney function using excretory GRF?

A

International CKD Classification System

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7
Q

Regarding the International CKD Classification System, what is meant by Stage 1?

A

Kidney damage but normal or high GFR >90 ml/min/1,73m2

->btw the 1.73/m2 is per squared meter of body or something

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8
Q

Regarding the International CKD Classification System, what is meant by Stage 2?

A

Kidney damage with a mild reduction in GFR
GFR = 60-89 ml/min/1.73m2

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9
Q

Regarding the International CKD Classification System, what is meant by Stage 3a/b?

A

Moderately impaired

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10
Q

What is the GFR for classification 3a?

A

45-59 ml/min/1.73m2

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11
Q

What is the GFR for classification 3b?

A

30-44 ml/min/ 1.73m2

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12
Q

Regarding the International CKD Classification System, what is meant by Stage 4?

A

Severely impaired
GFR= 15-29 ml/min/1.73m2

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13
Q

Regarding the International CKD Classification System, what is meant by Stage 5?

A

Advanced or on dialysis
GFR= <15 ml/min/1.73m2

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14
Q

One of the ways to asses kidney function, as well as seeing how much is excreted out, is seeing how much of the stuff required by the body is being kept in.

What can cross the glomerular basement membrane?

A

Electrolytes
Creatinine

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15
Q

One of the ways to asses kidney function, as well as seeing how much is excreted out, is seeing how much of the stuff required by the body is being kept in.

What can cross the glomerular basement membrane but gets reabsorbed in the proximal tubule?

A

Glucose

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16
Q

One of the ways to asses kidney function, as well as seeing how much is excreted out, is seeing how much of the stuff required by the body is being kept in.

What cannot cross the glomerular basement membrane?

A

Cells e.g. WBCs, RBCs
High molecular weight proteins e.g. albumin, globulins

17
Q

Will there be any blood or protein in the urine if kidneys are filtering properly?

A

No

18
Q

How can it be found if there is any blood or protein in the urine?

A

Urinalysis - dipstick

19
Q

What is used to determine the protein quantification in urine?

A

Protein creatinine ratio

20
Q

Give the definition of chronic kidney disease.

A

Either:
GFR <60ml/min/1.73m2
OR
the presence of kidney damage e.g. abnormal blood, urine or x-ray findings

THAT IS PRESENT FOR >3MONTHS

21
Q

What is the most common cause of CKD?

A

Diabetes

22
Q

Which imaging is used to detect causes of CKD?

A

Ultrasound

->non-invasive, no ionising radiation, may provide information about kidney size

23
Q

What does a small kidney indicate?

A

Chronic problem as has shrivelled up over time

24
Q

What is given to the patient for a kidney biopsy?

A

Local anaesthetic

25
Q

What the most important factor in slowing the rate of renal decline?

A

BP control

26
Q

Which drugs can be used to control proeinuria?

A

ACEi/ARBs
SGLT2 inhibitors

27
Q

Okayyyy so
The kidneys have an endocrine function and has a role in the production of erythropoietin and vitamin D metabolism.
If the kidneys were damaged, what would the knock-on effect be on the endocrine function of the kidney?

A

Anaemia
Hypocalcaemia

28
Q

Okayyyy so
The kidneys have a role in BP.
If the kidneys were damaged, what would the knock-on effect be on this function of the kidney?

A

Hypertension

29
Q

Okayyyy so
The kidneys have a role in body fluid homeostasis and urine production.
If the kidneys were damaged, what would the knock-on effect be on this function of the kidney?

A

Fluid overload

30
Q

Okayyyy so
The kidneys have a role in excretion of physiological waste e.g. urea.
If the kidneys were damaged, what would the knock-on effect be on this function of the kidney?

A

Uraemia
Drug toxicity

31
Q

Okayyyy so
The kidneys have a role in electrolyte balance.
If the kidneys were damaged, what would the knock-on effect be on this function of the kidney?

A

Hyperkalaemia etc

32
Q

Okayyyy so
The kidneys have a role in acid-base homeostasis.
If the kidneys were damaged, what would the knock-on effect be on this function of the kidney?

A

Acidosis

33
Q

What is the main treatment for CKD?

A

Renal replacement therapy

34
Q
A

Year 2- Urinary (22 decks)

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