CKD Flashcards

1
Q

a spectrum of different pathophysiologic
processes associated with abnormal kidney
function and a progressive decline in GFR

A

Chronic Kidney Disease

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2
Q

ESRD results to

A

UREMIC SYNDROME
(dialysis or transplantation)

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3
Q

pathophysiology of CKD

A
  1. initiating mechanisms specific to the
    underlying etiology
    abnormalities in kidney development, immune complex deposition,
    inflammation, toxin exposure
  2. set of progressive mechanisms
    (hyperfiltration and hypertrophy) with long term reduction in renal mass
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4
Q

increase pressure and flow—- distortion of glomerular architecture,
abnormal podocyte function, disruption of filtration barrier— sclerosis and drop
out of the remaining nephrons

A

maladaptive

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5
Q

Decrease nephron numbers

A
  • vasoactive hormones,
  • cytokines,
  • growth factors
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6
Q

Risk Factors for CKD

A
  • small for gestational birth weight
  • childhood obesity
  • hypertension
  • diabetes
  • autoimmune disease
  • advanced age
  • African ancestry
  • family hx of kidney disease
  • AKI
  • Proteinuria/sediment
  • structural abnormalities
  • Mendelian: ADPKD
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7
Q

Leading Categories of Etiologies of CKD

A
  • Diabetic nephropathy
  • Glomerulonephritis
  • Hypertension
  • Autosomal dominant polycystic kidney disease
  • Other cystic and tubulointerstitial nephropathy
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8
Q

KDIGO Classification of CKD

  • <30 mg/g
  • <3 mg/mmol
A

A1

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9
Q

KDIGO Classification of CKD

  • 30-300 mg/g
  • 3-30 mg/mmol
A

A2

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10
Q

KDIGO Classification of CKD

  • > 300 mg/g
  • > 30 mg/mmol
A

A3

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11
Q

KDIGO Classification of CKD

  • > /=290
A

G1: Normal or high

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12
Q

KDIGO Classification of CKD

  • 60-89
A

G2: Mildly decreased

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13
Q

KDIGO Classification of CKD

  • 45-59
A

G3a: Mildly to moderately decreased

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14
Q

KDIGO Classification of CKD

  • 30-44
A

G3b: Moderately to severely decreased

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15
Q

KDIGO Classification of CKD

  • 15-29
A

G4: Severely decreased

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16
Q

KDIGO Classification of CKD

  • <15
A

G5: Kidney failure

17
Q

Cockcroft- Gault Formula

A

(72) (creatinine)

18
Q

Signs and Symptoms of CKD and Uremia:
HYPERNATREMIA

A
  • Intake > urinary excretion
  • extracellular fluid volume expansion
  • hypertension
19
Q

Treatment for ECVF Expansion:

Stage 3-5 CKD

A
  • Thiazide
  • Loop furosemide
  • Unresponsive: higher dose/ metolazone
20
Q

decrease vitamin K dependent
regeneration of matrix GLA protein

A

warfarin

21
Q

Tx:
- Livedo reticularis
- Patches of ischemic necrosis
Legs, thighs, abdomen, breast

A
  • hyperbaric O2
  • IV thiosulfate
  • discontinue drugs
22
Q

progressive dose reduction as renal function
deteriorates

A

Insulin