CKD Flashcards
What is the definition of CKD?
reduced GFR and/or evidence of kidney damage- 2 measurements 3 months apart
How is GFR assessed?
estimated by creatinine clearance
Why does creatinine clearance over-estimate GFR
creatinine is secreted by tubules
What is creatinine produced?
muscle breakdown- muscular people produce more creatinine
How is creatinine adjusted?
corrected for women, black race and age by MDRD4 equation
What GFR is accurate for?
if GFR is less than 60ml/min
What must serum creatinine be in order for eGFR to be valid?
serum creatinine must be stable
How does eGFR affect actual GFR if muscle mass is low?
over-estimates
What is stage 1 CKD?
GFR >90ml/min with evidence of kidney damage
What is stage 2 CKD?
GFR 60-90ml/min with evidence of kidney damage
What must be present for a diagnosis of stage 1 or 2 CKD?
evidence of kidney damage
How are stages 3-5 CKD defined?
on GFR alone
What is evidence of kidney damage?
proteinuria; haematuria (in absence of LUT cause) or abnormal imaging
What is stage 3 CKD?
GFR 30-60
What is stage 4 CKD?
15-30
What is stage 5 CKD?
<15 GFR OR ON RENAL REPLACEMENT THERAPY
What risks does CKD increase?
CVS
Which patients are more likely to progress with CKD?
those with proteinuria; and younger patients (have longer to progress)
What are the common causes of CKD?
DM; HT; vascular disease; chronic glomerulonephritis; reflux nephropathy; polycystic kidneys
Why is the cause of CKD not always known?
many patients present late with small scarred kidneys which could be caused by lots of things
At what GFR do symptoms of decreased GFR appear?
<20ml/min
What are the symptoms of reduced GFR?
tiredness; poor appetite; itc and sleep disturbance
What is the most common type of polycystic kidneys?
autosomal dominant which presents in adulthood
What are the principles of managemnet of CKD?
slow progression; reduce CVS risk; treat complications of CKD and prepare for renal replacement therapy
