Chronic kidney disease

Question 1

What is CKD?

Answer 1

Progressive loss of renal function due to numerous conditions.

Question 2

5 stages of CKD…

Answer 2

Stage 1: >90ml/min per 1.73m2
Stage 2: 60-89
Stage 3: 30-59
Stage 4: 15-29
Stage 5 <15

Question 3

Clinical features of stage 4 and 5 CKD

Answer 3

• anorexia and lethargy
• polydyspia and polyuria
• faltering growth/ growth failure
• bony deformities from renal osteodystropny
• hypertension
• acute-on-chronic renal failure
• incidental finding of proteinuria
• unexplained normochromic, normocytic anaemia

Symptoms rarely develop before renal function falls to <1/3 of normal or stage 4 CKD

Question 4

Causes of CKD?

Answer 4

• renal dysplasia +/- reflux
• obstructive uropathy
• glomerular disease
• congenital nephrotic syndrome
• tubulointerstitial diseases
• renovascular disease
• polycystic kidney disease
• metabolic

Question 5

Management of CKD?

Answer 5

Prevent the symptoms and metabolic abnormalities to allow normal growth and development and preserve residual renal function

• prevention of renal osteodystrophy with vit D supplements, phosphate restriction
• control of salt and water balance and acidosis
• control anaemia
• recombinant human growth hormone to treat growth resistance
• dialysis and transplantation