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Nephrology > CKD > Flashcards

CKD Flashcards

1
Q

What are the risk factors for CKD?

A

diabetes, HTN, CVD, AKI, fam hx, systemic disease e.g. SLE

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2
Q

What is the most common cause of CKD?

A

diabetic nephropathy

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3
Q

Which is the best test to assess for proteinuria?

A

albumin:creatinine ratio

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4
Q

What is the management of CKD?

A

BP control

Glycaemic control

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5
Q

Name a feature of advanced CKD?

A

renal anaemia- due to reduced production of EPO

renal bone disease

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6
Q

Give four results that would help to determine whether renal failure is acute or chronic

A

USS- small kidneys, duplex collecting duct
FBC- anaemia of chronic disease
PTH- raised in chronic renal failure
Bone profile- low calcium, high phosphate

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7
Q

Give four clinical features/lab findings that would help you decide whether dialysis is necessary

A

U+Es: hyperkalaemia
SOB: pulmonary oedema
VBG: metabolic acidosis
Confusion/flap/chest pain: uraemic complications e.g. pericarditis, encephalopathy

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8
Q

Three causes of chronic renal failure/ disease?

A 
DM
HTN
GN
Polycystic disease
Drugs
Pyelonephritis
SLE
Myeloma and amyloidosis
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9
Q

Burr cells are a feature of which condition?

A

CKD

Sea urchin edges/shape of RBC on blood film

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10
Q

Three investigations for CKD?

A 
Blood tests
Urine dips, PCR, bence jones proteins
CXR
Renal US
CT KUB
Bone XR
Renal biopsy
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11
Q

Name five blood tests you would conduct when investigating CKD

A 
Bone profile
Glucose
FBC
PTH
Immune- ANA, ANCA, GBM, C3, C4, Ig, Hep
Blood film
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12
Q

Three complications of CKD?

A 
CDV disease
Oedema
HTN
Electrolyte disturbances
Anaemia (of chronic disease)
Sensory neuropathy 
Leg restlessness 
Renal osteodystrophy
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13
Q

Name two features of renal osteodystrophy

A

Osteoporosis: ↓ bone density
Osteomalacia: ↓ mineralisation of osteoid (matrix)
2/3 HPT → osteitis fibrosa cystica
 Subperiosteal bone resorption
 Acral osteolysis: short stubby fingers
 Pepperpot skull

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14
Q

Pepperpot skull is a sign of which condition?

A

Hyperparathyroidism

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15
Q

A urine:albumin ratio above which level is significant?

A

> 3 mg/mmol

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16
Q

Below which eGFR is required to diagnosed CKD?

A

<60, therefore G2, or proteinuria

17
Q

Is Albumin: Creatinine (ACR) a blood or urine test?

A

urine, albumin should not be present in urine, creatinine is cleared steadily

18
Q

Three aims of CKD management?

A

slow progression of disease
reduced CVD risk
Reduce risk of complications
Treat complications

19
Q

What is the definition of CKD?

A

kidney damage or GFR <60 ml/min/ 1.73m2 for 3 months or more

20
Q

List two issues associated with creatinine as a parameter for measuring disease

A
  1. Slow recognition of loss of the first 70% of renal function 2. Surprise at the sudden rise in creatinine with late renal referral 3. Overestimation of function in women 4. Overestimation of function in elderly 5. Overestimation in other low muscle mass groups e.g. amputuees, RA, para/quadraplegics
21
Q

List three problems with using eGFR

A
  1. Not validated in elderly 2. Only accurate below 60ml/min 3. Not valid in AKI 4. Pregnancy 5. Only validated in whites and african americans
22
Q

State 5 measures to slow progression of CKD

A
  1. BP control 2. Diabetic control 3. Diet 4. Smoking cessation 5. Lower cholesterol
23
Q

Name two problems seen in CKD patients are not helped by dialysis?

A

anaemia, renal bone disease, endocrine disturbances, neuropathy

24
Q

In the context of CKD, explain why someone might appear breathless

A

low bicarbonate due to failing kidneys, resp compensation by lowering CO2

25
Q

Four indications for commencing dialysis?

A 
Acidosis
Electrolyte imbalances
Intoxication
Oedema
Uraemia
26
Q

Name three types of renal replacement?

A

Haemodialysis
Peritoneal dialysis
Renal transplant

27
Q

Name two option for haemodialysis access

A
  1. Arteriovenous fistula
  2. Tunelled cuffed catheter- internal jugular vein
  3. AV graft
28
Q

Name two types of peritoneal dialysis

A

Continuous ambulatory

Automated (night)

29
Q

Name two complications of haemodialysis

A

thrombosis
infection
Aneurysm

30
Q

Name two complications of peritoneal dialysis

A

weight gain
bacterial peritonitis
psychosocial effects

31
Q

Name three pros of renal transplant

A
  1. No dialysis 2. Live more independently 3. Fertility better 4. Better life expectancy
32
Q

Name three cons of renal transplant

A
  1. Immunosuppressive medication 2. Increased CDV risk 3. Increased infection 4. Malignancy

Nephrology (8 decks)

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