CKD Flashcards
What are causes of renal failure?
DM SLE Hypertension Urinary tract obstruction Hypercalcaemia Chronic pyelonephritis PCKD Glomerularnephritis Amyloid PAN Interstitial nephritis
What are they symptoms of renal failure?
Often asymptomatic Nausea Anorexia Itchy Lethargy Nocturia Impotence later: Oedema Chest pain Dyspnoea Confusion Fits Pleural effusion Metabolic flap Raised BP Retinopathy
What are the signs of renal failure?
Yellow tinge to skin Metabolic flap Oedema Raised BP Retinopathy
What investigations should be done for renal failure?
U+E Urine dip MC+S Cr Albumin:Cr Glucose FBC eGFR PO4 ESR USS
What are eGFR stages of CKD?
1= >90 (normal kidney function but damaged) 2= 60-89 3= 30-59 4= 15-29 -severe eGFR reduction 5= <15 FAILURE
What testing frequency for eGFR should there be before stage 3?
Yearly
What testing freq should there be at stages 3, 4 and 5?
3= 6 monthly 4= 3-6 monthly 5= 6 weekly
How do you treat renal failure?
Stop nephrotoxic drugs
Monitor eGFR
Manage CVD risk- cholesterol and BP
Treat anaemia and bone disease
What is the target BP for those with renal failure?
130/80
What antihypertensives should be used in renal failure?
ACEi or ARBs first line
When does dialysis start?
Stage 5
What are issues that arise in renal transplat?
Rejection Persistent high BP and cholesterol Atherosclerosis Renal artery stenosis Obstruction at anastomoses Malignancy from immunosuppression Infection secondary to immunosuppression
What is CAPD?
Continuous ambulatory peritoneal dialysis- permanent in peritoneum and fluid inserted and changed throughout the day
What are issues with haemodialysis
Pulmonary oedema Infection U+E imbalance BP issues Aluminium toxicity Time!
What are nephrotoxic drugs?
Lithium NSAIDs Contrasts for scans Gentamycin Diuretics ACEi/ARBs Metformin
