Chronic Kidney disease Flashcards
What defines chronic kidney disease?
Reduced kidney function and/or structural damage for 3 months with reduced GFR and abnormal creatinine and albumin
What is the significance of CDK1 vs CDK5?
CDK1: normal kidney
CDK5: renal failure (renal replacement therapy). Means GFR is <15
What are the 2 main risk factors for chronic kidney disease?
Hypertension, diabetes
What characterizes the following diseases?
a) chronic pyelonephritis
b) interstitial nephritis
chronic tubulointerstitial inflammation
Inflamed space between tubules)
Name 8 complications of chronic kidney disease?
- Loss of renal function (can’t excrete waste) and end-stage renal disease
- Hypervolemia: CVS disease, peripheral neuropathy
- Bone disorder: parathyroid overcompensates for lack of calcitriol by producing too much PTH -> bone breakdown
- Malignancy: thyroid, renal tract
- Malnutrition
- Renal anemia: no EPO
Three symptoms a patient with chronic kidney disease may present with
Muscle cramping (hypocalcemia due to less calcitriol), poor appetite, frequent urination (night)
*may have no symptoms until an advanced stage
9 signs of chronic kidney disease
Pallor (anemia), cachexia, dehydrated, tachypnoea, HTN, raised JVP, peripheral edema, frothy urine
Which investigations should you do on the patient? (6)
Albumin creatinine ratio (ACR) >3mg/mmol
Urine sediment and electrolyte abnormalities
Biopsy/imaging
eGFR
Nephrotoxic drugs?
What are hematinics? Give 3 examples
Nutrients required for RBC formation: B12, folate, iron
What is the function of dialysis?
Maintain euvolemia (weight) and electrolytes
*corrects acidosis: allows bicarbonate to diffuse into blood
Why is a fistula needed for dialysis?
If punctured too often: veins collapse and arteries - ischemia
- produces a thrill
- arterialized vein (connected to an artery)
What is a graft/line? What are the pros and cons?
Synthetic plastic to join vein-artery, punctured for dialysis
Pros: don’t need to wait for it to arterialize
Cons: infection, venous drainage damaged over time (swollen neck/face)
What are the differences between hemodialysis and peritoneal dialysis?
Hemodialysis: blood pumped out
Peritoneal: pumping fluid into peritoneal cavity (peritoneum is semi-permeable membrane)
*fewer side effects, gentle/daily, bacterial peritonitis
How do you match a renal transplant?
Matching HLA: human leukocyte antigen
What are the benefits of a renal transplant over dialysis?
Cost-effective, better QOF, , corrects symptoms and metabolism
