Chronic Kidney Disease

Question 1

def

Answer 1

either a pathological abnormality (haematuria +/ proteinuria) or a reduction in GFR <60ml/min/1.73m^2 for >3months

Question 2

what is the a normal GFR

Answer 2

90ml/min/1.73m^2

Question 3

epi

Answer 3

common in adult population

increases with age

Question 4

risk factors

Answer 4

DM
HTN
elderly

Question 5

aetiology

Answer 5

1 DM
2 HTN

less common causes include:
polycystic kidney disease
glomerular nephrotic or nephritic syndromes

Question 6

what is the most common cause of CKD

Answer 6

DM

Question 7

what is the definition of nephropathy in DM

Answer 7

macroalbuminuria (>300mg albumin/24hrs) +/ reduction in the GFR to <90ml/min/1.73m^2 within 10 yrs of DM diagnosis

Question 8

history

Answer 8

1 fatigue (CKD results in lack of erythropoeitin which causes anaemia)
2 ankle swelling as there is salt and water retention with reduced renal function
3 N+V, itching, due to accumulation of toxic waste products (uraemia)

Question 9

what infections are associated with glomerular disorders

Answer 9

hep B/C

Question 10

what sorts of urine can indicate CKD

Answer 10

“foamy-appearing urine” which indicates proteinuria

“coca-cola urine” which indicates haematuria

Question 11

examination

Answer 11

1 oedema (salt and water retention with impaired renal function)
2 enlarged prostate (may be a rarer cause of CKD which causes swelling of the kidney)

Question 12

investigations

Answer 12

1 bloods
-high creatinine
-reduced GFR
2 urine
-haematuria +/ proteinuria are markers for kidney damage
-microalbuminuria is a risk factor for CKD, and is associated with DM and HTN
3 renal USS
-CKD has small atrophied kidneys

Question 13

a 54y/o man with a 10yr history of DM + HTN with complications of diabetic retinopathy and peripheral neuropathy presents with fatigue and weight gain over 3/12. Has intermittant nausea. O/E the man is obese with a BP of 158/92, there is peripheral oedema.

Answer 13

CKD