CKD

Question 1

CKD Aetiology

Answer 1

-Old age, diabetes, hypertension, obesity and CVD

Question 2

CKD RFs

Answer 2

• CVD
• Proteinuria
• AKI
• HTN
• DM
• Smoking

Question 3

CKD Classification

Answer 3

• Increased ACR and decreased GFR increase risk of adverse outcomes
• Stage 1: normal- >90 with other evidence of CKD
• Stage 2: mild impairment- 60-89 with other evidence of CKD
• Stage 3a: moderate- 45-59
• Stage 3b: moderate- 30-44
• Stage 4: severe- 15-29
• Stage 5: established renal failure- <15 or on dialysis
• Suffix p denotes presence of proteinuria
• eGFR >60 without other evidence does not mean CKD
• Other evidence of chronic kidney damage includes: persistent microalbuminuria, proteinuria, haematuria

Question 4

CKD Presentation

Answer 4

• Usually asymptomatic
• Symptoms only usually develop in severe stages
• Symptoms include anorexia, nausea, vomiting, fatigue, weakness, pruritus, lethargy, peripheral oedema, dyspnoea, insomnia, muscle cramps, pulmonary oedema, nocturne, polyuria, headache

Question 5

CKD Differentials

Answer 5

• AKI (differentiating can be difficult)

- Renal ultrasounds will almost always show abnormalities in CKD

Question 6

CKD Investigations

Answer 6

• Assessment of renal function
• U&Es
• USS
• AXR or CT if stones

Question 7

CKD Management

Answer 7

• eGFR monitoring
• ACEi, statin
• CCB if statin not tolerated
• Targets below 140/90
• 130/80 if diabetic (with CKD)