Chronic Kidney Disease

Question 1

how long must kidney damage or decreased kidney function be present for before it is diagnosed CKD

Answer 1

3 months

Question 2

what is normal GFR

Answer 2

90-120ml/min

Question 3

when will creatinine be raised

Answer 3

when 60% of total kidney function is lost

Question 4

what category of people have a normally raised serum creatinine

Answer 4

african americans, because of higher muscle mass

Question 5

where does creatinine come from

Answer 5

muscle breakdown

Question 6

what can you estimate from serum creatinine

Answer 6

GFR - there is a relationship

Question 7

what additional information is necessary to calculate eGFR from serum creatinine

Answer 7

age, weight, gender, race

Question 8

CKD stages

Answer 8

by GFR levels
1 = >90
2 = 60-89
3a = 45-59
3b = 30-44
4 = 15-29
5 = <15

Question 9

a GFR of 42 is what stage CKD

Answer 9

3b

Question 10

what is the range of CKD stage 2

Answer 10

60-89

Question 11

what stage of CKD is a GFR of 19

Answer 11

stage 4

Question 12

test to check blood and protein in urine

Answer 12

dipstick test

Question 13

3 approaches to assessing kidney function

Answer 13

what they manage to excrete
what they manage to keep in
the anatomy of the kidneys

Question 14

definition of CKD

Answer 14

proteinuria, haematuria, abnormal x-ray findings or GFR<60 for >30 months

Question 15

cost of dialysis per year per patient

Answer 15

£35,000

Question 16

prevalence of CKD

Answer 16

8-12% with up to 50% in >70

Question 17

most common causes of CKD

Answer 17

diabetes and hypertension

Question 18

5 key causes of CKD

Answer 18

diabetes, hypertension, glomerulonephritis, renovascular disease, polycystic kidney disease

Question 19

what surgery might you want to do in someone with a declining GFR

Answer 19

arteriovenous fistula - in preparation for dialysis

Question 20

4 approaches of CKD management

Answer 20

1. treat underlying cause
2. slow the rate of renal decline
3. prevent complications
4. prepare for RRT

Question 21

CKD blood investigations

Answer 21

urea, creatinine, electrolytes
bicarbonate
proteub
LFT
Ig
FBC
just basically assessing funciton and looking for cause

Question 22

CKD urine investigations

Answer 22

urinalysis dipstick
protein:creatinine ratio
24 hour urine collection

Question 23

CKD imaging

Answer 23

X-ray

ultrasound (good for showing calyxes)

Question 24

other CKD investigations

Answer 24

biopsy

Question 25

how do you slow the rate of renal decline

Answer 25

controlling BP and proteinuria, and treat underlying cause

Question 26

from BMJ what are the 1st investigations to order in CKD

Answer 26

serum creatinine
urinalysis
urine microalbumin
renal ultrasound
eGFR

Question 27

alphabet of CKD complications

Answer 27

Acidosis/Anaemia
Bone disease
CV risk
Death and Dialysis
Electrolytes
Fluid Overload
Gout
Hypertension

Question 28

how can you remember the complications of CKD

Answer 28

just think about the functions of a healthy kidney and what will lack in reduced function

and sure that alphabet thing but it’s pish

Question 29

if somebody has hyperparathyroidism and CKD what specific treatment will they need

Answer 29

cinacalcet (mimics action fo calcium) and an active vit D analogue (calcitriol)

Question 30

what is the primary treatment of CKD below stage 4/5

Answer 30

BP control