Chronic Kidney Disease Flashcards
What are some of the physiological waste products dealt with at the kidney?
Creatinine
Urea
Drugs
What endocrine role do the kidneys play?
Produce EPO
Important in VitD metabolism
How do we estimate GFR/
Serum creatinine clearance
How is creatinine produced?
Break down product of muscle
At what stage will creatinine begin to rise?
When GFR is 60% of normal
What are the determinants which can alter serum creatinine between individuals?
Muscle mass Age Gender Weight Ethnicity
What equations are used to estimate GFR from serum creatinine?
Cockcroft Gault
MDRD 4 variable equation (clinical)
What CKD staging will be observed in individual with >90 GFR?
1 - Normal
What CKD staging will be observed in individual with 60-89 GFR?
2 - mild reduction
What CKD staging will be observed in individual with 30-45 GFR?
3- Moderately impaired
What CKD staging will be observed in individual with 15-29 GFR?
4- Severely impaired
What CKD staging will be observed in individual with <15 GFR?
5- Advanced or on dialysis
How do we measure filtration function of the kidneys?
Use estimation of GFR (eGFR) from creatinine blood tests
What abnormalities may you seen in urine?
Blood
Protein
What test allows for the identification of blood/protein in urine?
Urinalysis (dipstick)
How can you quantify protein in urine?
PCR (protein creatinine ratio)
What is the definition of CKD?
Defined by either the presence of kidney damage or GFR <60 that is present for >3 months
Which area of population most likely to get CKD?
Elderly
What are the main risk factors for developing CKD?
Diabetes Glomerulonephritis Hypertension Renovascular disease Polycystic kidney disease
What investigations may we do to understand the underlying aetiology of CKD?
FBC U&Es Creatinine LFTs Urinalysis USS Renal biopsy
Renal disease is often ____.
Asymptomatic
What are the benefits of USS?
No radiation
Non-invasive
What can be easily identified with USS?
Hydronephrosis
What is the most important thing to control when trying to decrease the decline of renal function?
Blood pressure
What drugs may be given in CKD to reduce BP?
ACE-inhibitors
ARBs
Why do CKD patients become anaemic?
Stop producing EPO required for RBC production
What vitamin may CKD patients become deficient in?
VitD
Why might a patient with CKD become acidotic?
Unable to produce HCO
What are the different ways to prevent fluid overload in CKD patient?
Reduce salt intake
Fluid restriction
Diuretics
What other system in the body is usually affected in renal patients?
CVS
In kidney disease, why make bone disease be observed?
Elevated Phosphate levels which leads to resorption of Ca from bones
