Chronic Kidney Disease

Question 0

List some causes of CKD including some common diseases.

Answer 0

Immunologic- glomerulonephritis
Infection- pyelonephritis
Genetic- PCK
Obstruction and reflux nephropathy

Diabetes, hypertension, atherosclerotic vascular disease, ischaemic heart disease.

Question 1

What is CKD

Answer 1

The irreversible and sometimes progressive loss of renal function over a period of months to years.

Question 2

Describe stage 1 CKD.

Answer 2

GFR >90. Kidney damage with normal or increased GFR. Need other evidence of kidney damage e.g. USS.

Question 3

Describe stage 2 CKD.

Answer 3

GFR 60-89. Kidney garage with mild GRF fall. Need other evidence of kidney damage.

Question 4

Describe stage 3 CKD.

Answer 4

GFR 30-59. Moderate fall in GRF. Usually without symptoms.

Question 5

Describe stage 4 CKD.

Answer 5

GFR 15-29. Severe fall in GFR. Symptoms present.

Question 6

Describe stage 5 CKD.

Answer 6

GFR <15 or RRT. Established renal failure. Symptoms present.

Question 7

What are the complications of CKD?

Answer 7

Anaemia

Renal bone disease

Question 8

How does anaemia occur in patients with CKD?

Answer 8

Decreased erythropoietin production.
Resistance to erythropoietin.
Decreased RBC survival.
Blood loss.

Question 9

Describe the process leading to renal bone disease.

Answer 9

GRF decreases. Phosphate accumulates, causing serum calcium to decrease. PTH increases leading to osteitis fibrosa cystica. Impaired renal function also prevents vitamin D from being activated leading to osteomalacia.

Question 10

List some modifiable risks of CKD.

Answer 10

Lifestyle- smoking, obesity, lack of exercise
Diabetes
Hypertension
Hyperlipidaemia

Question 11

What are the indications for dialysis?

Answer 11

Uraemic symptoms
Acidosis
Pericarditis
Hyperkalaemia
Fluid overload