Chronic Kidney Disease Flashcards
What is CKD?
Chronic Kidney Disease is a descriptive term used for deteriorating kidney function of any underlying cause for > 3months
What are the stages of CKD and the GFR associated with each stage?
Stage 1 = GFR >90 Stage 2 = GFR 60-89 Stage 3a = GFR 45 - 59 Stage 3b = GFR 30 - 45 Stage 4 = GFR 15-29 Stage 5 = GFR <15
What does ACR stand for?
Albumin creatinine ratio
What are the stages of ACR?
A1 = <3 A2 = 3-30 A3 = >30
What are some non-specific symptoms of CKD?
- Fatigue
- Weight loss/loss of appetite
- Fluid retention
- Dry, itchy skin
- Bone pain
- Nocturia (increased urination at night)
- Polyuria (protein in the urine)
- Parathesia and tetany (spasms)
What are the main causes of CKD?
- Congenital/Inherited Disease
- Urinary Tract Obstruction
- Vascular Disease
- Glomerular Disease
- Tubulointerstitial disease
What investigations are useful?
- Serum biochemistry
- Urine biochemistry
- Urine microscopy
- Urinalysis
What are some of the complications of CKD?
- Anaemia
- CKD mineral bone disease
What is anaemia often caused by in CKD?
Deficiency in erythropoietin
What treatment can be given for anaemia caused by erythropoietin deficiency?
- Oral iron, sometimes not well tolerated
- IV iron, used if oral iron is not well tolerated
- ESA (erythropoietin stimulating agents) if Hb is not within ideal range - Hb 100-120
What is the management for hypertension?
- ACE inhibitor
- ARB
- CCB
What is the management for anaemia due to erythropoietin deficiency?
- ESA (erythropoietin stimulating agents)
What is the management for CKD mineral bone disease?
- Reduce phosphate intake in diet
- Phosphate binders with meals
- Vitamin D supplement
What is the management for severe CKD?
Replacement Renal Therapy:
- Dialysis
- Transplant
