chronic kidney disease Flashcards
what is chronic kidney disease?
irrevisible deterioration to kidney and its function
over 3 months
who is it common in? top causes
risk factors
renal tract obstruction RAS PCKD minimal change disease renal limited vasculitis myeloma diabetes hypertension glomerular disease -glomerulneorphitis chronic NSAID use proteinuria AKI smoking malignancy haematuria aki aloport syndrome see increasing age African and Asians > white congential kidney disease/ PCKD
symptoms
Retionopathy restless leg syndrome Electrolye disturbance Sexual dysfunction Increased BP Nail changes
Percarditiis Parathyroid overactivity Painful big toe Pulmonary oedema Perphieral and proximal neuropathy Pigmentation of skin and nails Purittis Pallor
BIG BEANs- Breathless, itchy, gout, bone pain/osteoporosis malacia, reduced energy, anaemia, ankle swelling neuropathy
others: nausea vomiting bruising sexual dysfunction oligomenhorrhea, infertility fractures ballot able kidney, palpable liver, peptic ulceration, anorexia
investigations
monitor eGFR Bloods- low Hb, low cal, high PTH, increased ESR serum urea, creatinine egfr increased K, increased alk phosphate CT USS protein/albumin: creatinine ratio
Management
aABG -acidosis Bloods-reduced Hb, Catheter and cannula Dipstick and dietary protein restriction Eelectrolyes and ecg USS-exclude obstruction
stop nephrotoxic drugs
how to differientate from
bilaterally small kidney anaemia low Ca increased Phosphate compare to previous bloods and egfr diabetes common olioguria occurs later stage high BP whereas Low BP in AKI
normal creatinine
70-150umol/L
drugs to consider when prescribing
HAL DIAMOND heparin acei lithium diueretics digoxin metformin opoids metformin nsaids iv contrast
treatment of it if risk of cvd
aspirin
atovostatin for all pt
when is renal replacement therapy needed
end stage kidney function grr<20 dialysis needed when less than 10 haemodialysis 4hr 3x week peritoneal dialysis kidney transplantation
if severe, palliative management
problems with kidney transplantation
immunosuppression needed
how often is monitoring needed with G1,2,3,4,5
G1 >90 annually g2 60-89 annually g3 45-59 6 monthly g3 30-44 3 monthly g2 15-29 3 monthly g1 <15 6 weekly
