CKD disease part 3 Flashcards
Pathophysiology of CKD Progression
Initial structural damage depends on the primary disease affecting the kidney
Majority of progressive nephropathies share a final common pathway to irreversible renal damage and ESRD
The key elements of this pathway are:
loss of nephron mass
glomerular capillary hypertension
proteinuria
loss of nephron mass
proteinuria
Alot of different disease states that cause glomerular cell injury or increase in blood pressure are what is having a role in progression of chronic kidney disease
ACE and ARBS have an effect where?
efferent arteriole
NSAIDs can cause an effect where?
afferent arteriole
ACE/ARBs can cause vasodilation on efferent arteriole by inhibiting actions of angiontensin
NSAIDs cause vasoconstriction on afferent arteriole causing reduced blood flow to the kidney
It’s not good if we have reduced blood flow to the kidney because kidneys aren’t able to work effectively as they were
ACE/ARBs are having an effect on your efferent arteriole and your also taking a diuretic that can cause AKI because taking all those medications at one time
When ACE/ARBs are working by themselves its fine but in combination with other medications its nephrotoxic
Etiology of CKD-Susceptibility Factors
Useful for identifying individuals at high risk of developing
CKD
Advanced age, low birth weight or reduced kidney mass at baseline, premature babies are born with smaller kidneys, low income or education, racial minority,family history, dyslipidemia
Diabetes and Hypertension are directly causing damage to your kidneys :(
Etiology of CKD-Initiation Factors
Directly cause CKD-Hypertension and ___________
Start the cycle of nephron loss
Diabetes
Etiology of CKD-Progression Risk Factors
Results in faster decline in kidney function
Predictors of Progression of CKD
Level of albuminuria
Age
Sex (Female more at risk than male pts)
Elevated ________
Hyperglycemia
Dyslipidemia
Elevated blood pressure
If a pt has EGFR of 50 and we don’t their chronic kidney function to progress anymore what would we be concerned about that could happen to the pt overtime?
We don’t want pt to develop what?
______________, mineral bone disease disease, __________disease, development of things like the need for renal replacement therapy so pts need to go on dialysis or have a kidney transplant, cognitive impairment from the buildup of toxins and waste
Increased risk of infection
Hyperparathyroidism
Anemia,
cardiovascular
Patients with chronic kidney disease with a reduced GFR are at an increased risk of death from any cause of cardiovascular events and hospitalizations
