Chronic kidney disease Flashcards
What is chronic kidney disease?
abnormal structure or function
What does CKD often coexist with?
diabetes
cardiovascular disease
How is CKD diagnosed?
minimun of two samples at least 90 days apart - eGFR (or creatinine)
At what stage and above would someone have a reduced excretory renal function and therefore an increased cardiovascular risk?
G3a (eGFR of <45)
What is a normal amount of albumin?
<3
What level of albumin indicates proteinuria?
> 30
Why does albumin leak out of the glomerulus?
if there is widespread endothelial and vascular disease
How often should you monitor people with AKI for CKD?
for 2-3 years after their AKI
When should people be tested for CKD?
diabetes hypertension AKI cardiovascular disease structural renal tract disease recurrent renal calculi prostatic hypertrophy SLE family history of end stage kidney disease or heriditary kidney disease
What comprises an accelerated progression of CKD?
sustained decrease of GFR of 25% or more
change in GFR catagory within 12 months
sustained decrease in GFR of 15ml/min/1.73m per year
What makes up the referral criteria for CKD?
GFR less than 30
ACR 70
ACR 30 with haematuria
sustained decrease of GFR by 15 in 12 months
sustained decrease of GFR by 25% or more
hypertension that is poorly controlled desipite the use of 4 drugs
artery stenosis
What should the blood pressure aims be for patients with CKD?
140/90
What should the blood pressure aims be for patients with CKD and diabetes?
130/80
What is the normal physiological response of ACEis and ARBS on GFR and creatinine?
GFR = 25% decrease creatinine = 30% increase
What should be given to all with CKD for cardiovascular disease prevention?
Atorvastatin
