CKD Flashcards
What is the first sign seen in ADPKD?
Hypertension (increased diastolic)
What is the pharmacological treatment for ADPKD?
Tolvaptan
Competitive ADH antagonist
What are the key things to measure in CKD?
Creatinine, blood pressure and urine dipstick.
Why is fluid restriction important in CKD?
To control hypertension
Why is nocturnal polyuria seen in CKD?
Reduced GFR + high solutes = osmotic diuresis
What does GFR have to be less than to cause hyperkalemia?
<20
Give 2 causes for hyperkalemia in CKD.
Decreased GFR = decreased secretion = increased retention
Nephron loss -> less RAAS -> more K retention
Name some drugs that should be stopped in hyperkalemia.
ACEi
ARBs
K+ sparing diuretics (amiloride and spironolactone)
Trimethoprim
Give some rasons why anaemia may occur in CKD.
Describe the protocol behind anaemia management in CKD.
Decreased EPO Functional iron deficiency (hepcidin) Vit B12 and folate ACEi (EPO supression) Uraemia - bone marrow supression Uraemia (+ acidosis) reduced RBC life span
Initially check iron - then supplement oral or IV
If normal check Hb and start EPO stimulating agents (ESA and Epo)
What is the Mx for CKD-BMD?
Reduce phosphate intake
Phosphate binders
1-alpha cal diol
Vitamin D
How is acidosis treated in CKD?
NaHCO3 tablets
Give 3 contraindications to haemodialysis.
Failed vascular access
Heart failure
Coagulopathy
Give some complications of HD.
Lines - infection, thrombosis and venous stenosis
AVF - thrombosis, bleeding, access failure and steal syndrome
CVS instability
Chronically unwell feeling
Give some contraindications for PD.
Peritoneal membrane fialure
Adhesions (previous surgery, stoma, hernia)
Pt or carer unable to connect and disconnect
Obese/ larger muscle mass with relatively smaller peritoneum
Give some complication of PD.
Peritonitis
Leaks - scrotal and diaphragmatic
Development of hernia
Ultrafiltration failure
