Chronic kidney disease

Question 1

CKD?

Answer 1

Progressive loss of kidney function over a period of months or years, the presence of kidney damage or decreased kidney function (i.e. eGFR < 60 ml/min per 1.73 m2) for three months or more.

Question 2

CKD classifications?

Answer 2

stage 1; eGFR > 90 ml/min per 1.73 m2 with other evidence of CKD (microalbuminuria, proteinuria, haematuria, structural abnormalities, biopsy showing glomerulonephritis), stage 3; moderate; eGFR 45M59 ml/min per 1.73 m2, stage 5; established; eGFR < 15 ml/min per 1.73 m2 or on dialysis.

Question 3

CKD risk factors?

Answer 3

age, DM, hypertension, obesity, cardiovascular disease, smoking, arteriopathic renal disease, nephropathies, family history, neoplasia, myeloma, chronic NSAIDs.

Question 4

CKD epidemiology?

Answer 4

common, often associated with other diseases.

Question 5

CKD symptoms?

Answer 5

often asymptomatic,

in severe; anorexia, nausea and vomiting, fatigue, pruritus, peripheral oedema, muscle cramps, pulmonary oedema.

Question 6

CKD signs?

Answer 6

rare to show any,

skin pigmentation, excoriation marks, pallor, hypertension, peripheral oedema, peripheral vascular disease.

Question 7

CKD investigations?

Answer 7

1. assess renal function (urea, creatinine, gold standard is isotopic GFR),
2. glucose for diabetes,
3. potassium,
4. serology (antibodies; ANA for SLE, c-ANCA for ganulomatosis with polyangiitis (Wegener’s), Anti-GBM for Goodpasture’s syndrome) Hepatitis and HIV serology)
5. USS for structural abnormalities,
6. X-ray KUB for stones.