CKD Flashcards
most common cause of death in CKD (and why many people don’t end up on dialysis
die of CVS disease first (associated comorbidity)
how to test for CKD
serum creatinine - used to calculate eGFR
- early monring urine AL:CR
- haematuria
2 most common causes of CKD which needs dialysis
- Hypertension.
- Diabetes mellitus.
other causes of CKD
- IgA nephropathy
- Nephrotoxic drugs
- BPH
- Neurogenic bladder
- SLE
- Vasculitis.
- Myeloma.
- PKD
- Alport’s syndrome
- Familial glomerulonephritis.
what may be raised in the blood in CKD
uraemia
clinical features of uraemia
anorexia
pruritus!!!
drowsy/confused
complications of uraemia
uraemic encephalopathy
- bleeding
- pericarditis
complications of CKD
- uraemia
- met bone disease
- met acidosis
- hypocalc
- fluid retention
- HTN
- anaemia
why does CKD cause metabolic bone disesae
increased PTH (due to a) hyperphosphataemia and b) decreased activation of vit D by the kidney leading to decreased bowel absorption of Ca) -> bone resorption
medical rx metabolic acidosis
IV sodium bicarb
5 functions of the kidney
fluid balance erythropoietin activation of vit d regulate acid base! (pumps out H, sucks in HCO3) waste/toxin/drug excretion
what is creatinine? which blood test measures it?
waste product of muscle metabolism
purely excreted by kidneys
U+Es
problem with urinalysis for detecfting proteinuria? what can you use instead?
doesn’t give quantification
is affecfted by dilution of urine
ACR (alb creat ratio)
can microalbuminuria be dected on dipstick?
no -> use ACR instead
if you half proteinuria……
…half the risk of ending up on dialysis
