CKD

Question 1

What is CKD?

Answer 1

Abnormal Kidney structure/function ≥3 months, irreversible.

Question 2

Criteria for CKD?

Answer 2

eGFR <60 OR PMH of renal damage (e.g. albumin/proteinuria, hematuria, abnormal U&Es)
2 tests w/3 month separation.

Question 3

Common causes of CKD?

Answer 3

Most common: Diabetes, Hypertension + GN

Others: lingering AKI, nephrotoxic drugs, systemic disease (e.g. myeloma, vasculitis), genetic (polycystic kidneys).

Question 4

Staging of CKD?

Answer 4

Stage 1: eGFR >90 + signs of Renal Damage
Stage 2: eGFR <90 + signs of Renal Damage
Stage 3: 3A) eGFR <60 3B) eGFR <45
Stage 4: eGFR < 30
Renal Failure: eGFR <15

Question 5

Common Signs of CKD?

Answer 5

Common Causes: Hypertension, PMH/Signs of Diabetes + haematuria, protein/albuminuria
Uraemia: pericardial rub (uraemic pericarditis), Flap (uraemic encephalopathy)
Examination: Ballotable kidneys, catheter/catheter scars (dialysis), Pitting Oedema

Question 6

Investigations for suspected CKD?

Answer 6

1) Arrange eGFR test
2) Urine: dipstick (haematuria), urinalysis (A/P:CR)
3) Bloods: FBC, U&Es, HbA1C, auto-antibodies bone profile, hepatitis serology - differentiate cause
4) Renal ultrasound - suspected obstruction

Question 7

Management for CKD?

Answer 7

1) Refer to Nephrology (oncology - isolated frank haematuria)
2) Slow progression: treat cause + lifestyle change
3) Treat complications e.g. Loop diuretics (oedema), Bicarb replacement (DKA).
4) Dialysis/Kidney Transplant.