Chronic Kidney Disease Flashcards
what is CKD
an irreversible and progressive loss of kidney function
what happens to the renal cortex in CKD
It shrinks as it is replaced by fibrous tissue
what are the causes of CKD
diabetes, hypertension, infection, genetic, polycystic kidne, Alport’s syndrome, obstruction
what investigations are carried out in CKD
FBC, Us and Es, PTH, CRP, ultrasound, biopsy, CT/MRI
when wouldn’t you biopsy a kidney after an ultrasound
When they’ve been seen to have shrunken as you would only be able to biopsy fibrous tissue
why might you give someone statins if they have CKD
lipids can increase the risk of CKD and make it worse
what is the inheritance pattern of polycystic kidney
autosomal dominant
which genes carry the mutation in polycystic kidney
PKD1 or PKD2
what may be seen on an ultrasound in CKD due to obstruction
hydronephrosis
what is hydronephrosis
swelling of the kidneys due to a build up of urine
what are the complications of CKD
anaemia, mineral bone disease, uraemia, hyperkalaemia, acidosis
why do patients get anaemia in CKD
the kidneys no longer produce erythropoietin causing RBCs to have a shorter lifespan
medications like ACE inhibitors suppress the bone marrow
describe mineral bone disease
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
what is uraemia
build up of waste products
what are the 3 options for renal replacement therapy
haemodialysis, peritoneal dialysis, renal transplant
what is haemodialysis
where blood is taken from an artery and filtered for 4 hours
occurs 3 times a week or overnight
what are the advantages of haemodialysis
less responsibility, you get days off from dialysis
what are the disadvantages of haemodialysis
travel time, chronically tired, highly restricted food/fluid intake, lots of accompanying medications
what are the complications of haemodialysis
Infections, CVS instability, chronic fatigue
what is peritoneal dialysis
where a needle is inserted into the abdomen, draining into bags that are either changed throughout the day or overnight
what are the advantages of peritoneal dialysis
less dietary restrictions and more freedom
what are the disadvantages of peritoneal dialysis
responsibility, frequent bag exchanges
when may peritoneal dialysis not be recommended
if the patient is overweight with previous history of abdominal surgery as there may be adhesions
what are the complications of peritoneal dialysis
leaks, high risk of peritonitis, hernia development
