Chronic Kidney Disease Flashcards
what is CKD?
irreversible and progressive loss of kidney function
what happens to the renal cortex in CKD
it is replaced by fibrous tissue so shrinks
what are the causes of CKD
diabetes hypertension infection genetic - polycystic kidneys, Alport's obstruction
what investigations are carried out in CKD
full blood count, U and Es, PTH, CRP
ultrasound
biopsy
CT/MRI scan
when wouldn’t you biopsy a kidney after ultrasound
when they’ve been seen to be shrunken as you would only be able to biopsy fibrous tissue
why may statins be given in CKD
as lipids increase the risk of CKD or makes it worse
what inheritance pattern does polycystic kidney disease have
autosomal dominant
which genes may be mutated in polycystic kidney disease
PKD1 or PKD 2
what may be seen on ultrasound in CKD due to obstruction
hydronephrosis
what are the complications of CKD
anaemia mineral bone disease uraemia hyperkalemia acidosis
why do patients get anaemia in CKD
less EPO production
RBCs have a shorter life span
medications e.g. ACE inhibitors
uraemia suppresses bone marrow
describe mineral bone disease
the kidneys can no longer filter phosphate as well giving a build up - this prevents the activation of vitamin D
vitamin D is needed for calcium reabsorption so you get hypocalemia - this causes PTH production
the PTH causes bone breakdown (osteodystropy) then phosphate and calcium can then bind to give non-bone calcifications
what is uraemia
build up of waste products
what are the 3 options for renal replacement therapy
haemodialysis, peritoneal dialysis and transplant
what is haemodialysis
where blood is taken from an artery and filtered for 4 hours 3 times a week or at night
what are the advantages of haemodialysis
less responsibility, get days off from dialysis
what are the disadvantages of haemodialysis
travel time, tired, restriction on food/fluids, take lots of medications
what are the complications of haemodialysis
infection, CVS stability, chronically feeling unwell
what is peritoneal dialysis
where a needle is inserted into the abdomen - you either change your own bags throughout the day or have it done over night
what are the advantages of peritoneal dialysis
self-sufficient, less fluid/food restrictions, easy to travel
what are disadvantages of peritoneal dialysis
frequent bag exchange, repsonsibilty
when may peritoneal dialysis may not be given
obese patients
patients with previous abdominal surgeries due to adhesions
what are the complications of peritoneal dialysis
leaks, peritonitis, hernia development
