CKD

Question 1

CKD - diagnosis + usual finding (what are the exceptions?)

Answer 1

USS - bilateral small kidneys

exceptions - diabetic nephropathy + ADPKD

Question 2

CKD - symptoms

Answer 2

fatigue
anorexia
N+V
SOB
itching - hyperphosphataemia - also causes hyperPTH
bone pain, gout - hyperuraemia
numb/tingling feet (neuropathy) - amyloid, diabetes

Question 3

CKD - causes

Answer 3

HIDDEN - idiopathic
HTN
Infection - eg ureteric reflux in childhood
Drugs
Diabetes
Exotica - SLE, vasculitis
Nephritis - esp GN

Question 4

CKD - indications for dialysis

Answer 4

endstage (5) - GFR < 15
symptomatic uraemia despite treatment
volume overload despite treatment
other - pericarditis, bone disease, hyperkalaemia despite treatment

Question 5

peritoneal dialysis peritonitis - presentation + investigations

Answer 5

abdo pain ± fever
cloudy bag - urgent microscopy + culture from first cloudy bag (they should keep it)
exit site infection - swab it
blood cultures if ill

Question 6

peritoneal dialysis peritonitis - management

Answer 6

gram + staph or MRSA - intraperitoneal vancomycin
gram - or pseudomonas - IV cipro
uncertain - use both empirically

Question 7

mnemonic for features of CKD

Answer 7

BIG BEAN - kidney is big bean
Breathlessness
Itching
Gout
Bone pain - osteodystrophy
Energy levels low
Ankle swelling/oedema
Neuropathy