CKD Flashcards
1
Q
what is this?
A
chronic reduction in kidney function
2
Q
outline stages as per GFR
A
G1 = eGFR>90
G2= 60-89
G3a= 45-59
G3b= 30-44
G4= 15-29
G5= <15 aka end stage renal failure
3
Q
causes?
A
- DM
- HT
- age related decline
- polycystic kidney disease
- glomerulonephritis
- drugs ie NSAIDS
4
Q
presentation?
A
usually asymptomatic but can also present w
- itching
- oedema
- nausea
- loss of appetite
- peripheral neuropathy
5
Q
Ix?
A
- eGFR- measured by doing U&E
- Proteinuria
- measured with urine albumin:creatinine ratio
- hAEMATURIA
- 1+ on dipstix significant
- Renal USS
6
Q
what is a significant urine albumin:creatinine ratio finding?
A
>3mg/mmol
7
Q
complications of CKD?
A
- anaemia
- renal bone disease
- cardiovascular disease
- metabolic acidosis
- peripheral neuropathy
8
Q
when do you refer someone w CKD to a specialist?
A
eGFR < 30
9
Q
Mx?
A
- slow progression of disease
- optimise glycaemic control / HT
- treat GN
- reduce risk of complications
- lifestyle measures
- atorvastatin for primary prevention of CVD
- manage complications
- anaemia- iron supplements first, then exogenous EPO
- metabolic acidosis- sodium bicarbonate
- bone disease- active vit D, low phosphate diet & bisphosphonates
- end stage renal disease- dialysis / transplant
10
Q
what do you use to treat HT in someone w CKD?
A
ACEI
11
Q
what must you monitor in someone who is taking ACEI on a background of CKD?
A
K as BOTH can cause hyperkalaemia
12
Q
X-Ray changes in renal bone disease?
A
“rugger jersey” appearance of spine - denser white at both ends of vertebra (sclerosis) and less white in centre (osteomalacia)
