CKD Flashcards
What is the definition of CKD?
Kidney damage or a persistent decreased GFR of less than 60ml/min/1.73m² for atleast 3 month
What are the stages of CKD?
Stage 1: kidney damage with normal or increased GFR >90ml/min/m²
Stage 2: moderate reduction 60-89
Stage 3a: moderate reduction 45-59
Stage 3b: moderate reduction 30-44
Stage 4: severe reduction 15-29
Stage 5: kidney failure <15
What are the signs and symptoms of CKD?
-stages 1-3 usually asymptomatic
-Stage 4 & 5 show signs of metabolic acidosis:
Decrease cognitive function
Muscle weakness
Loss of body mass
Peripheral edema and pulmonary edema
Skin manifestation (dry, pruritic, echymosis)
GI (anorexia, nausea)
Platelet dysfunction
Erectile dysfuntion
Depression
HF
Should we screen for CKD in asymptomatic adults without RF?
لا
What are the 2 main causes of CKD?
Diabetes
Hypertension
Who should screening be done to?
Those with risk factors including:
Age grrater than 60
Family history of kidney disease
Obese
Cardiovascular disease
What screening tests should be done for CKD
GFR
Proteinurea
Albumin/creatinine ratio (same as diabetes)
Which equation is used to estimate GFR?
Creatinine-cystatin C equation
What is the normal GFR?
90ml/min/m² or higher
How do you slow down CKD progression?
Maintain BP <130/80
HbA1c <7%
Lifestyle mod: smoking cessation diet, exercise
SGLT2 inhibitors: for diabetes
When should screening for develipment of complications start?
Stage 3 and above
How do we screen for the development of complications?
Screen for metabolic bone disease:-
Stage 3: measure Ca, bicarbonate, PTH, phosphorous, ALP, vitamin D once
Stage 4: measure PTH, Ca and phosphorous every 3 month
Stage 5: measure Ca and phosphorous every month
When do we refer a CKD patient to nephrology?
GFR<30
Rapid drop in GFR
Significant albuminurea
Hematuria
Unknown cause of CKD
HTN not relieved by >4 agents
2ndary hyperparathyroidism
