Chronic kidney disease

Question 1

Chronic kidney disease

Answer 1

Decreased kidney function persisting for 3 > months or sustained fall in GFR to <60ml /min per 1.73m2

Question 2

Pathophys of CKD

Answer 2

1. Compensate for injury by increasing filteration through remaining nephrons
2. Hypertrophy and vasodilation of remaining nephrons
3. Increased glomerular pressure causes scarring of the glomerulus and progressive damage
   CHRONIC KIDNEY DISEASE CAN PROGRESS TO END STAGE RENAL DISEASE WHERE TRANSPLANT OR DIALYSIS IS NEEDED

Question 3

Causes of CKD

Answer 3

1. Diabetes mellitus

2. Hypertension - causes chronic glomerular nephritis

Question 4

Stage 1 CKD

Answer 4

normal or high GFR (GFR > 90 mL/min)

Question 5

Stage 2 CKD

Answer 5

Mild CKD (GFR = 60-89 mL/min)
Stage 3A Moderate CKD (GFR = 45-59 mL/min)
Stage 3B Moderate CKD (GFR = 30-44 mL/min)
Stage 4 Severe CKD (GFR = 15-29 mL/min)
Stage 5 End Stage CKD (GFR <15 mL/min)

Question 6

Stage 3A CKD

Answer 6

Stage 3A Moderate CKD (GFR = 45-59 mL/min)

Question 7

STAGE 3B CKD

Answer 7

Stage 3B Moderate CKD (GFR = 30-44 mL/min)

Question 8

STAGE 4 CKD

Answer 8

Stage 4 Severe CKD (GFR = 15-29 mL/min)

Question 9

STAGE 5 CKD

Answer 9

Stage 5 End Stage CKD (GFR <15 mL/min)

Question 10

Invest for CKD

Answer 10

• Ultrasound of Kidney to show scarring

* Serum creatinine is raised

Question 11

Hypertension as a cause of CKD

Answer 11

1. Glomerulus to thicken to withstand high pressure
2. Lumen narrows as a resut
3. Reduced bloodflow -> reduced GFR
4. Activates RAAS system
5. Blood pressure increased further
6. Glomerularsclerosis - scarring

Question 12

Diabetes as a cause of CKD

Answer 12

1. Excess glucose sticks to proteins in efferent arterioless
2. Arterioles stiffen and become narrower
3. Increases pressure within glomerulus
4. Hyperfiltration -> glomerularslcrosis

Question 13

Clinical manifestations of CKD

Answer 13

1. Azotemia - build up of urea and toxins
2. Encephalopathy - asterexis ( tremor of hands)
3. Pericarditis - pericardial rub
4. Hyperkalemia - cardiac arrythmia
5. No erythropoetin - anaemia
6. Unable to activate vit D - hypocalcemia (renal osteodystrophy)