CKD Flashcards
description
abnormal kidney structure or function
kidney damage ie albuminuria
decreased kidney function ie eGFR <60ml/min
for 3 months or more
epidemiology
common
coexists with other conditions eg CVD, DM
risk increases with age
aetiology
in developed countries, often ass. w/: old age diabetes HTN obesity CVD
other associations:
arteriopathic renal disease
glomerulonephritis
infective, obstructive and reflux nephropathies
FHx of stage 5 CKD or hereditary kidney disease eg polycystic kidneys
hypercalcaemia
multisystem disease with renal involvement eg SLE
neoplasms
myeloma
risk factors
CVD proteinuria AKI HTN DM smoking african, african-caribbean, asian chronic NSAID use untreated urinary outflow obstruction
classification
stage 1:
normal - eGFR >90 with other evidence of chronic kidney damage
stage 2:
mild - eGFR 60-89 with other evidence of kidney damage
stage 3a:
moderate - eGFR 45-59
stage 3b:
moderate - eGFR 30-44
stage 4:
severe - eGFR 15-29
stage 5:
established renal failure (ERF) - eGFR <15 or on dialysis
the suffix (p) indicates proteinuria
evidence of chronic kidney damage
persistent microalbuminuria persistent proteinuria persistent haematuria structural abnormalities, seen on USS eg polycystic kidneys, reflux nephropathy biopsy proven glomerulonephritis
presentation
usually asymptomatic
often unrecognised
Sx
usually only in severe CKD anorexia n&v fatigue weakness pruritus lethargy peripheral oedema dyspnoea insomnia muscle cramps pulmonary oedema nocturia polyuria headache
sexual dysfunction is common
in very severe: hiccups pericarditis coma seizures
signs
skin pigmentation or excoriation pallor HTN postural hypotension peripheral oedema LVH PVD pleural effusions peripheral neuropathy restless legs syndrome
DDx
AKI
acute on chronic
control of HTN
ACE-i monotherapy safe in CKD
