Chronic Kidney Disease

Question 1

Abnormalities in kidney function must be present for how long to diagnose CKD?

Answer 1

≥ 3 months

Question 2

A eGFR of what must be present to diagnose CKD in the absence of kidney damage?

Answer 2

60ml/min/1.73m2 for > 3 months

Cannot eat for 12 hours before test

Question 3

What do symptoms usually become apparent in CKD?

Answer 3

Stage 4 (out of 5)

Question 4

What are the main causes of CKD?

Answer 4

Diabetes
Glomerulonephritis
Idiopathic

Question 5

What skin changes may be present in CKD?

Answer 5

Lemon tinge - uraemia & itchy skin

Question 6

What correction factor must be applied for eGFR in afro-carribean?

Answer 6

x1.2

Question 7

What type of people have a normally high createnine?

What type of people have a normally low createnine?

Answer 7

Muscular men

Skinny women

Question 8

What is micro-albuminuria?

Answer 8

Increased albumin excretion in urine

Question 9

An albumin createnine ratio of what is clinically significant for CKD?

Answer 9

moderate: 3-30mg/mmol - in non diabetics
severe: > 30

Diabetic male: 2.5
Diabetic female: 3.5

Question 10

eGFR is not a reliable indicator in which groups of people?

Answer 10

Pregnant

< 18

Question 11

What is the acute management of CKD?

Answer 11

Nephrotoxins - NSAIDs, contrast, metformin
Furosemide - if fluid overload
Sodium bicarbonate - if acidotic

Question 12

What is the management of CKD?

Answer 12

ACE-i if high BP (reno-protective)
Statins - 15-20mg - modify QRISK2
Anti platelet - aspirin - stroke risk

Question 13

What is the target BP in someone with CKD?

Answer 13

<140/90

Question 14

Why are CKD patients at risk of anaemia?

Answer 14

Decreased EPO release - decreased Hb

Give recombinant EPO