CKD Knowledge Flashcards
What are the 6 main causes of CKD?
Type 2 Diabetes Type 1 Diabetes Hypertension Polycystic Kidney Glomerulopathies Lupus/sickle cell
What are the three types of Renal Failure?
Acute Renal Failure (sudden, injury or drugs)
CKD (slow, illness, toxins)
Chronic renal failure/ESRD (is stage 5 of CKD, 75% of nephrons are damaged)
What is GFR?
Glomerular Filtration Rate. It is the best measure of kidney function. It is used to check how well kidneys are working.
What is eGFR? What is it calculated based on?
Estimated Glomerular Filtration Rate. It estimates how much blood passes through the glomeruli each minute. eGFR is estimated based on blood creatinine levels, age, gender, height, race, weight
Who created the 5 stages of CKD?
The National Kidney Foundation
What are the characteristics associated with Stage 1 kidney disease?
Kidney Damage
GFR that is normal or over 90
Generally no symptoms
What is stage 2 of CKD?
Kidney Damage GFR of 60-89 Usually no symptoms May be evidence in MRI of CT scans Higher levels of creatinine and urea in the blood
What is stage 3 CKD?
Kidney Damage
GFR of 30-59
Uremia can develop
Patients more likely to develop high blood pressure, anemia, bone disease
What is Stage 4 CKD?
Advanced Kidney Damage
GFR of 15-30
More likely to develop high blood pressure, anemia, bone disease, heart disease
Patients should prepare for kidney replacement
What is stage 5 CKD?
This also known as ESRD
GFR of 15 or less
The kidneys lose nearly all ability to function effectively
Kidney replacement therapy is needed
When does CMS start paying for treatment for CKD patients?
If Creatinine is less than 6 (in a patient with diabetes) or 8 (in a orient without diabetes)
What is Uremia and what are its signs?
Uremia is a buildup of urea in the blood due to lack of normal kidney function
Signs include:
- headache, fatigue, fuzzy thinking
- loss of appetite
- shortness of breath
- swelling
- nausea and vomiting
- severe itching
- high blood pressure
What treatment options are there for CKD?
Peritoneal dialysis
Hemodialysis
Kidney transplant
No treatment
How do you get a kidney transplant?
A living related donor is required. If you don’t have one you can go on the national donor list.
What is the range of outcomes for kidney transplantation?
50% do very well, 35% do pretty well, 15% develop problems
Kidney transplantation is a treatment, not a cure
Do patients have a right to stop their treatment?
Yes, it must be informed and voluntary.
In Stage 5 patients they will die in a few weeks
What are the types of Peritoneal Dialysis?
CAPD (continuous ambulatory Pd) CCPD (Continuous cycle Pd)
What are some benfits and downsides to PD?
Advantages: You can do it yourself Continuous treatment No needles Improved sleep
Disadvantages: Having an external catheter in the abdomen Risk of infection (peritonitis) Daily treatment required Weight gain Activity restrictions
Explain how a dialyzer works
Inside a dialyzer are over 10k hollow fibers that are semipermeable
Blood is on the inside of the fibers
The dialysate solution is an electrolyte and sugar bath
Water diffuses across the fiber membrane through ultrafiltration (pressure differential)
Toxins and electrolytes diffuse across the membrane due to concentration differentials
What are some pros and cons of hemodialysis?
Pros:
Treatments administered by professionals
Social interaction
3 times a week only
Cons:
Need to get to clinic
Diet and intake restrictions
Advanced planning required for travel
What are some pros and cons of home hemodialysis?
Pros:
Patient in control
No need to travel to center
Cons:
Patient responsible for setup, cleanup and ordering supplies
Need to be ready to deal with emergencies
Requires a partner
What is nocturnal dialysis
Dialysis performed at night with longer times and slower flow rates
3-6 nights per week
Requires a dedicated center
What does the kidney transplant list look like?
There are over 72,000 people on the waiting list
3000 people are added each month
12,000 kidney transplants are performed each year
What is CKD? How is it defined?
CKD is chronic disease. It is defined as the condition where patients kidneys can no longer function properly
