Chronic Kidney Disease Flashcards
Causes of CKD
• CKD can be caused by:
• high blood pressure – over time, this can put strain on the small blood vessels in the kidneys and stop the kidneys working properly
• diabetes– too much glucose in your blood can damage the tiny filters in the kidneys
• high cholesterol – this can cause a build-up of fatty deposits in the blood vessels supplying your kidneys, which can make it harder for them to work properly
• kidney infections
• glomerulonephritis– kidney inflammation
• autosomal dominant polycystic kidney disease – an inherited condition where growths called cysts develop in the kidneys
• blockages in the flow of urine – for example, from kidney stones that keep coming back, or an enlarged prostate
• long-term, regular use of certain medicines – such as lithium and non-steroidal anti-inflammatory drugs (NSAIDs)
Chronic kidney disease
• Also known as Diabetic nephropathy is a
condition where high blood glucose and high blood pressure damage the glomerulus
• The kidneys’ ability to filter waste and excess fluids from the blood decreases,
leading to a reduced glomerular filtration
rate (GFR).
• This results in the accumulation of toxins and fluid retention in the body as well as proteins leaking into the urine ( a condition called albuminuria or proteinuria)
Estimated Glomerular filtration rate (eGFR).
• A glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 on at least two occasions separated by a period of at least 90 days (with or without markers of kidney damage).
• Normal GFR is healthy kidneys should be able to filter more than 90ml/min
• Note - eGFR is reported in millilitres per minute per 1.73m2, using a formula that takes body size into account
Stages and ACR
• A simple urine test called the urineNAlbumin:Creatinine ratio (ACR) is also performed to look for signs that protein is leaking into the urine
• The ACR is used to calculate the ‘A stage’ of CKD
• The eGFR and ACR scores are used to support diagnosis and treatment planning
Data and statistics (NICE)
• There is an estimated global prevalence of 9.1%, with diabetes mellitus accounting for 30-50% of cases.
• Prevalence is the proportion of a population who have a specific characteristic in a given time period, regardless of when they first developed the characteristic
• In the UK, over 1.9 million adults have been diagnosed with CKD, although there are many more who remain undiagnosed.
• The prevalence is expected to continue to increase due to an ageing population and a higher incidence of diseases such as type 2 diabetes and hypertension.
Summary
• CKD is caused by physical damage to the nephron.
• eGFR can be thought of as a percentage; 100-90% of effective kidney function to
less than 15% kidney failure
• Generally, CKD is progressive and leads to
end-stage renal disease (ESRD) although
Only around 1 in every 50 people
diagnosed with CKD will go on to develop
kidney failure and need renal
replacement therapy (dialysis treatment
or a transplant)
Treatments
• Medications to lower blood pressure Angiotensin-converting enzyme
(ACE) inhibitors are medicines that help relax the veins and arteries to lower blood pressure for example.
• Lifestyle changes to lower blood pressure and blood glucose to reduce and prevent further damage.
• Renal replacement therapy (RRT) – Dialysis and transplantation
