CKD

Question 1

What is CKD?

Answer 1

3 months or longer evidence of kidney damaged i.e. low eGFR/ protenurea/ haematurea

Fibrosis of the renal tubules and loss of function

Question 2

Causes of CKD?

Answer 2

T2D
HTN
Atherosclerotic renal sclerotic disease

Question 3

Symptoms of CKD?

Answer 3

• Anaemia (reduced EPO production)
• Bone disease (vit D not being produced)- osteoporosis, osteomalacia. Low Ca and high PTH
• Neurological symptoms- neuropathy (parestaesia and neuropathy), autonomic
• CVD- MI, cardiac failure, cardiac arrest and death
• Pericarditis due to accumulation of urea in blood.

Question 4

Long term mnagement of CKD?

Answer 4

Renal protection- to prevent kidney from getting more damaged:

• Aim of BP must be below 120/80.
• Proteinurea <0.3 g in 24h.

Reducing CVD risk:

• Statins
• Stop smoking
• HbA1C <7%

Question 5

What are complications of CKD?

Answer 5

• Hyperkalaemia needs to be managed. Stop ACEI and spironolactone
• Metabolic acidosis- give oral NaHCO (sodium bicarb)
• Infections- influenza and pneumoccocal vaccines.

Question 6

5 drugs used in renal transplant immunosupressive therapy?

Answer 6

• Corticosteroids
• Azathioprine
• Mycophenolate
• Tacrolimus
• Cyclosporine

Question 7

What factors are checked in kidney donations?

Answer 7

ABO compatibility and HLA

Kidney is placed in iliac fossa and is anastamosed with iliac vessels.

Question 8

Treatment of CKD?

Answer 8

• EPO and Iron- anaemia
• Phosphate binders (calcium carbonate)- to lower phosphate
• Vit D- to increase Ca
• Antihypertensives- HTN
• Diuretics- fluid overload
• Metabolic acidosis- give oral NaHCO (sodium bicarb)