CKD + AKI Flashcards
1
Q
Cause of CKD
A
Uncontrolled diabetes PCKD Glomerulonephritis HTN Pyelonephritis SLE
2
Q
Risk factors of CKD
A
Age > 50yrs Smoking Male Black/hispanic FMHx Diabetes HTN Autoimmune diseases - SLE Long term NSAIDs Obesity Nephrotoxic drugs - gentamycin
3
Q
Symptoms of CKD
A
Hyperuricaemia - pruritic HTN Hyperkalaemia - arrhythmia palpitations Anaemia - chronic disease and less EPO - fatigue - lethargy Hypocalcaemia - easier to fracture and bone pain Peripheral oedema
4
Q
Signs of CKD
A
Glycosuria Hyperkalaemia Hypocalcaemia Hyperparathyroidism Hyponatraemia Proteinuria - 3g + Haematuria Decreased eGFR
5
Q
Stages of CKD
A
Stage I - 90+ with proteinuria or haematuria
Stage II - 60+ with proteinuria or haematuria
Stage IIIa - 45- 60
Stage IIIb - 30 - 45
Stage IV - 15 - 30
Stage V - less than 15
6
Q
Potential impact on lifestyle with CKD
A
Dialysis
- frequent visits to hospital
- fluid restriction
- cannot travel
Transplant
- immunocompromised
7
Q
Ix for CKD
A
Bloods
- FBC
- U+Es
- LFTs
- eGFR
- Fe, Ca, phosphate
- Vit D
- PTH
BP Urine sample - blood - protein - Alb:Cr ratio - 3 mg/mmol ABG - metabolic acidosis USS - PCKD Biopsy - RCC DRE - obstructive uropathy
8
Q
Medication for CKD
A
Furosemide
HTN:
- Beta blocker
- Ramipril
- CCB
Cholesterol:
- Statin
Diabetes control: metformin
Hyperkalaemia:
- calcium gluconate
- Insulin + dextrose
- low K+ diet
Metabolic acidosis:
- sodium hydrocarbonate
9
Q
Advice for CKD
A
Fluid restrict Alcohol and smoking cessation Medication dose adjustment Avoid bananas and leafy veg - K+ Avoid NSAIDs
10
Q
Presentation of AKI
A
N+V Dehydration Diarrhoea Reduced urine output and colour change Confusion Fatigue Drowsiness
11
Q
Pre-renal causes of AKI
A
Sepsis - vasodilation
Hypovalaemia
Renal artery stenosis
12
Q
Renal cause of AKI
A
Acute tubular injurt Nephrotoxic medication - gentamycin, NSAIDs Contrast Chemotherapy Rhabdomyolysis ANCA vasculitis SLE
13
Q
Post renal causes of AKI
A
Kidney stone
Obstruction - BPH, tumour or retroperitoneal fibrosis
14
Q
Investigations for AKI
A
Volume status Reanal function - Serum Cr Bloods - K+ Urine dipstick - proteinuria - haematuria - leukocytes - infection or interstitial nephritis - nitrites - glucose
15
Q
Assessment of volume status
A
Capillary refill Skin turgor JVP BP Fluid input and output Oedema
