Chronic Kidney Disease (CKD) Flashcards
define
this is reduced GFR and/or evidence of kidney damage
causes
Vascular= hypertension, RAS GN Systemic= diabetes, myeloma, amyloidosis, vasculitis, SLE Genetic kidney diseases Obstructive
presentation
anaemia weight loss uraemia (lemon yellow, frost, encephalopathy, confusion, pericardial effusion, Kussmaul's, itch) pain psychiatric (diet restrictions)
diagnosis
minimum of 2 samples at least 90 days apart with eGFR
who should be tested for CKD?
hypertension diabetic AKI CVD structural renal disease recurrent calculi BPH SLE FH haematuria detection
define accelerated progression of CKD
sustained decrease in GFR of 25% or more and a change in GFR category within 12 months or sustained decrease in GFR of 15ml/min/1.73m2 per year
CKD results that require referral?
GFR <30 (G4 or G5) ACR >70 ACR >30 with haematuria decrease in GFR poorly controlled hypertension genetic cause suspected RAS suspected
management of CKD
- BP <140/90 (if diabetes <130/80)
- atorvastatin (decrease CVD)
- RRT
extra-renal consequences of CKD
CVD
CKD-MBD
renal anaemia
describe CVD in CKD
starts early with eGFR <50
management of CVD risk in CKD
smoking cessation weight loss, exercise limit salt hypertension control statins, aspirin
what is there potential for in CKD-MBD
secondary and tertiary HPT, vascular calcification and bone fractures
management of CKD-MBD
- phosphate restriction (binders)
- fluid, salt and K+ restriction if high
- alfacalcidol (active vit D)
- calcimimetic e.g. cinacalcet
what eGFR is renal anaemia associated with?
eGFR 45
diagnosis of renal anaemia
B12 and folate
ferritin
iron
TSats
