Chronic Kidney Disease

Question 1

Most frequent causes of CKD (that can lead to ESRD & dialysis)

Answer 1

1. Diabetic nephropathy
2. Hypertension (hypertensive glomerulosclerosis)
3. Glomerulonephritis
4. Idiopathic/unknown/undiagnosed
5. PCKD, urologic, congenital, sickle cell nephropathy, genetic, cardiorenal, hepatorenal, multiple myeloma, bilateral removal for cancer

Question 2

6 pillars of CKD that need to be managed (manage by physician on multidisciplinary team).

Answer 2

1. Anemia
2. Increased K
3. Bone disease
4. Acidosis
5. Hypertension
6. Preparing for dialysis

Question 3

Why are patients with CKD likely to be anemic?

Answer 3

Erythropoietin is produced in the kidneys (renal parenchyma). If there is not enough renal parenchyma (why??), eryhtropoietin production will decrease and bone marrow will not be stimulated to make RBCs.

Question 3

Why do patients with CKD develop hyperkalemia?

Answer 3

As GFR falls, the kidney may not be able to excrete the daily potassium load/intake. This may also be worsened by medications (NSAIDs, ACEi/ARBs/spironolactone).

Question 4

How do we treat people with CKD to avoid hyperkalemia?

Answer 4

• Restrict dietary potassium
• Stop any K-sparing diuretics
• Stop NSAIDs
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