Chronic Kidney Disease Flashcards

1
Q

what is CKD

A

an irreversible and progressive loss of kidney function

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2
Q

what happens to the renal cortex in CKD

A

It shrinks as it is replaced by fibrous tissue

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3
Q

what are the causes of CKD

A

diabetes, hypertension, infection, genetic, polycystic kidne, Alport’s syndrome, obstruction

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4
Q

what investigations are carried out in CKD

A

FBC, Us and Es, PTH, CRP, ultrasound, biopsy, CT/MRI

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5
Q

when wouldn’t you biopsy a kidney after an ultrasound

A

When they’ve been seen to have shrunken as you would only be able to biopsy fibrous tissue

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6
Q

why might you give someone statins if they have CKD

A

lipids can increase the risk of CKD and make it worse

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7
Q

what is the inheritance pattern of polycystic kidney

A

autosomal dominant

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8
Q

which genes carry the mutation in polycystic kidney

A

PKD1 or PKD2

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9
Q

what may be seen on an ultrasound in CKD due to obstruction

A

hydronephrosis

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10
Q

what is hydronephrosis

A

swelling of the kidneys due to a build up of urine

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11
Q

what are the complications of CKD

A

anaemia, mineral bone disease, uraemia, hyperkalaemia, acidosis

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12
Q

why do patients get anaemia in CKD

A

the kidneys no longer produce erythropoietin causing RBCs to have a shorter lifespan
medications like ACE inhibitors suppress the bone marrow

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13
Q

describe mineral bone disease

A

the kidneys are no longer able to filter phosphate properly, allowing it to buildup
this prevents the activation of vitamin D
vitamin D is needed for calcium reabsorption, so you get hypocalcaemia
this leads to an increase in PTH, causing bone breakdown
phosphate and calcium then bind forming non-bone calcifications

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14
Q

what is uraemia

A

build up of waste products

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15
Q

what are the 3 options for renal replacement therapy

A

haemodialysis, peritoneal dialysis, renal transplant

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16
Q

what is haemodialysis

A

where blood is taken from an artery and filtered for 4 hours
occurs 3 times a week or overnight

17
Q

what are the advantages of haemodialysis

A

less responsibility, you get days off from dialysis

18
Q

what are the disadvantages of haemodialysis

A

travel time, chronically tired, highly restricted food/fluid intake, lots of accompanying medications

19
Q

what are the complications of haemodialysis

A

Infections, CVS instability, chronic fatigue

20
Q

what is peritoneal dialysis

A

where a needle is inserted into the abdomen, draining into bags that are either changed throughout the day or overnight

21
Q

what are the advantages of peritoneal dialysis

A

less dietary restrictions and more freedom

22
Q

what are the disadvantages of peritoneal dialysis

A

responsibility, frequent bag exchanges

23
Q

when may peritoneal dialysis not be recommended

A

if the patient is overweight with previous history of abdominal surgery as there may be adhesions

24
Q

what are the complications of peritoneal dialysis

A

leaks, high risk of peritonitis, hernia development