Chronic Kidney Disease Flashcards
What are some abnormal pathological findings associated with CKD?
- diabetic glomerulosclerosis (hyaline nodules)
- benign nephrosclerosis
- renal artery stenosis
- renal atrophy
What are the top 4 primary causes of ESRD?
- diabetes
- hypertension
- glomerulonephritis
- cystic kidney
What are the criteria for CKD?
- presence of kidney damage or eGFR = 3 months AND
- not treated with dialysis or transplant
What is the GFR for the different stages of CKD?
- stage 1: >90
- stage 2: 60-89
- stage 3: 30-69
- stage 4: 15-29
- stage 5: <15
What co-morbid irises is CKD associated with?
- CV disease
- heart failure
- PVD
- stroke
How low does the GFR have to fall before it inevitably continues to decline, even if the original insult has been eliminated?
- 25%
What are the goals in treating renal disease progression?
- stop or slow the rate of GFR decline
- prevent additional kidney damage
- maintain nutritional status
- prevent or limit the complications of uremia
What are some specific treatments for renal disease progression?
- ACE inhibitors/ARBs
- tight BP control
- dietary protein restriction
- tight lipid control
- tight sugar control
What is the pathogenesis of CKD?
- hyperfiltration
- increased BP, proteinuria
- glomerulosclerosis
- renal failure
What are signs and symptoms of uremia?
- general: fatigue, weakness
- CV: hypertension, pericarditis
- GI: nausea, vomiting, diarrhea
- CNS: lethargy, confusion, coma
- muscles: myoclonic jerks, weakness
- bones: osteitis fibrosa cystica
- metabolic: acidosis, hyperphosphatemia, hyperkalemia, high BUN, high Cr
- endocrine: hyperparathyroidism
What do you get anemia with CKD (uremia)?
- iron deficiency
- EPO deficiency
- bone marrow fibrosis due to hyperparathyroidism
What happens to the size of the kidneys when CKD progresses to ESRD?
- atrophy
What is a common sign of ESRD upon physical examination of the patient?
- cachexia
What is the treatment for ESRD?
- establish access (AV fistula, AV graft, catheters)
- renal transplantation
