CKD

Question 1

What is Chronic Kidney Disease (CKD)?

Answer 1

CKD is a longstanding (>3 months) and usually progressive impairment in renal function, defined by GFR <60 mL/min/1.73 m² or persistent proteinuria.

Question 2

What are the main functions of the kidneys?

Answer 2

Metabolic (vitamin D metabolism), Endocrine (erythropoietin production), Regulatory (water/electrolyte balance), Excretory (waste removal).

Question 3

What is the definition of CKD based on duration and GFR?

Answer 3

CKD is defined as GFR <60 mL/min/1.73 m² or urinary albumin-to-creatinine ratio >65 mg/mmol for more than 3 months.

Question 4

What is the significance of proteinuria in CKD?

Answer 4

Proteinuria indicates chronic kidney damage and is a critical marker for CKD diagnosis and progression.

Question 5

What are the five stages of CKD?

Answer 5

Stage 1: GFR >90; Stage 2: GFR 60–89; Stage 3: GFR 30–59; Stage 4: GFR 15–29; Stage 5: GFR <15 (end-stage renal disease).

Question 6

What are the risk factors for CKD?

Answer 6

Diabetes, hypertension, age >60 years, family history of kidney disease, autoimmune diseases, nephrotoxic drugs, and smoking.

Question 7

What are the common causes of CKD?

Answer 7

Diabetic glomerulosclerosis, hypertension, glomerular diseases, tubulointerstitial diseases, cystic kidney diseases, and chronic obstructions.

Question 8

Why does CKD cause anemia?

Answer 8

Anemia is caused by reduced erythropoietin production, iron deficiency, and shortened red cell lifespan.

Question 9

What is renal osteodystrophy and its cause in CKD?

Answer 9

Renal osteodystrophy results from vitamin D deficiency, hypocalcemia, and hyperphosphatemia leading to secondary hyperparathyroidism.

Question 10

What electrolyte imbalances are common in CKD?

Answer 10

Hyperkalemia, hyponatremia or hypernatremia, hypocalcemia, hyperphosphatemia, and metabolic acidosis.

Question 11

What is the role of RAAS in CKD progression?

Answer 11

RAAS activation leads to efferent arteriolar vasoconstriction, increasing glomerular pressure and promoting scarring.

Question 12

What are the complications of CKD?

Answer 12

Cardiovascular disorders, anemia, bone disease, electrolyte imbalances, neuropathy, and fluid overload.

Question 13

How is hyperkalemia managed in CKD?

Answer 13

Calcium gluconate, glucose-insulin infusion, sodium bicarbonate, potassium binders, and dialysis if severe.

Question 14

What are the dietary recommendations for CKD patients?

Answer 14

Low protein, low phosphate, adequate calorie intake, and fluid restriction based on urine output.

Question 15

What is the target blood pressure for CKD patients?

Answer 15

Target blood pressure is <130/80 mmHg using ACE inhibitors, ARBs, or other antihypertensive medications.

Question 16

What medications are used to slow CKD progression?

Answer 16

ACE inhibitors, ARBs, and diuretics are used to slow progression by reducing proteinuria and controlling hypertension.

Question 17

What is the management for CKD-associated anemia?

Answer 17

Recombinant erythropoietin (rhEPO) and iron supplementation; target hemoglobin is 10–12 g/dL.

Question 18

What is the importance of avoiding nephrotoxic drugs in CKD?

Answer 18

Nephrotoxic drugs like NSAIDs and contrast agents can exacerbate CKD and cause acute kidney injury.

Question 19

How is CKD progression delayed?

Answer 19

Blood sugar control (HbA1c <7%), blood pressure control (<130/80), avoiding dehydration, stopping smoking, and weight reduction.

Question 20

What imaging is used in CKD and its significance?

Answer 20

Ultrasound for kidney size and structure, X-ray for bone disease, and angiography for vascular issues.