Chronic kidney disease

Question 1

Define

Answer 1

Impaired renal function for 3+ months

Question 2

Normal eGFR

Answer 2

> 90

Question 3

What do you do at each of the stages of kid

Answer 3

Stage 1 - normal or slight increase
Stage 3 - worrying
Stage 4 - start discussing renal replacement therapy

Question 4

What might you measure alongside eGFR

Answer 4

albumin creatinine ratio

Question 5

How does HTN cause eGFR

Answer 5

HTN damages blood vessels
in the kidneys, this thickens the afferent arteriole 
Therefore reduces GFR
Kidney releases renin
causes more vasoconstiction
Ischemia to kidney
CKD

Question 6

T2DM / diabetic nephropathy pathophysiology

Answer 6

Hyperglycemia -> ROS released ->mesangial
GBM sclerosis and thickening
Reduced GFR

Question 7

What are the functions of the kidney?

Answer 7

A WET BED
ACID balance
Water balance
Electrolyte balance
Toxin removal (incl. urea)
Blood pressure control
EPO 
D vitamin metabolism

Question 8

Electrolyte balance causes / what is seen on ABG

Answer 8

Metabolic acidosis causing tachypnoea, confusion

Question 9

Water balance issue causes

Answer 9

Periorbital oedema
Peripheral oedema
Pulmonary oedema

Question 10

Electrolyte imbalance causes

Answer 10

Hyperkalemia, arrythmia, muscle weakness

Question 11

Toxin removal issue causes

Answer 11

NV
Pruritis
skin yellowing
skin

Question 12

Vit D metabolism problems cause

Answer 12

osteomalacia
hypocalcemia
secondary hyperparathyroidism