chronic kidney disease Flashcards
CKD is present if either of the following is present for 3 or more months
- structural or functional abnormalities of the kidney, with or without decreased GFR
- GFR< 60 ml/min/1.73 with or without kidney damage
indication of CKD (2)
- proteinuria (albumin to creatinine ration > 30 mg/g)
2. history of kidney transplantation
risk factors for CKD
1. older age 2, family history 3. US racial/ethnic minority status, 4. diabetes 5. HTN 6. autoimmune dx
CKD develops when there is no apparent regulation of levels of
nitrogenous wastes
initial injury of one kidney leads the remaining kidney to maintain GFR and solute level. over time the adaptations are maladaptive and leads to
glomerular/tubular hypetrophy and fibrosis
what therapies do we consider with CKD
interefere with glomerular adaptations such as decrease PGC and decrease growth factors
true or false:
in ckd we want the Renin system to be activated
false; we want to inhibit it to lower blood pressure, decrease urine production and slow the decline in GFR
what type of diet do we want to avoid in CKD?
high protein diet
—- we want to reduce nitrogenous waste
GFR>90, widspread damage with albuminuria and is sever nephrotic syndrome occures
kidney damage with normal or increased GFR- G1
GFR= 60-90
kidney damage with midly reduced GFR- G2
GFR= 30-59
- common pathological features irrespective of cause
- tubular adaptations and systemic adaptations
moderately reduced GFR- G3
GFR= 30-59
- prepare for replacement therapy
- psychosocial preparation- lifestyle changes and dietary restrictions
- physical preparation- AV fistula, evaluation for transplant
severely reduced GFR- G4
GFR < 15
- common pathologic features of ESKD
- indications for renal replacement therapy
kidney failure - G5
AEIOU
A- acidosis E- electrolytes I- intoxication O- overload U- uremia
Acidosis clue for replacement therapy
metabolic acidosis that cannot be controlled with medical therapy such as NaHCO3
