CKD TCD Flashcards
Urine sediment with red blood cells and red blood cell casts
proliferative glomerulonephritis.
Pyuria and/or white cell casts suggest
interstitial nephritis (especially if eosinophils are present in the urine) or urinary tract infection (UTI).
Normal type of protein in urine?
Tamm–Horsfall glycoprotein (THP), also known as uromodulin, is a glycoprotein that is secreted by the renal tubules. Up to 150 mg/day of uromodulin may be excreted in the urine, making it the most abundant protein in normal urine.
What is the CKD eGFR boundary?
60
treatment for CKDMBD
alphacalcidol and phosphate binders
Normal size of healthy kidneys
11cm
Grading of CKD
1-5. 1 Kidney damage with normal or ↑GFR ≥ 90.
- Kidney damage with mild ↓GFR 60-89
- Moderate ↓GFR 30-59
- Severe ↓GFR 15-29
- Established Kidney Failure ≤ 15
Target PB in all stages of CKD
130/80
CKD stage for renal replacement therapy
CKD stage 4 `
simvastatin and amlodopine
Increased risk of myopathy and rhabdomyolysis in patients taking amlodipine and >20mg of simvastatin
Four common biochemical abnormalities in CKD
CKD Mineral Bone Disease (CKDMBD) – hypocalcaemia, hyperparathyroidism
Renal anaemia
Metabolic acidosis
Hyperkalaemia
Why might someone with late stage CKD be breathless?
Anaemia
Fluid overload/pulmonary oedema
Metabolic acidosis
Associated heart failure
Indications for dialysis
pH < 7.25 • K+ > 7 mmol • Fluid overload • Toxins (SLIME) • Creatinine > 400 • Uraemic pericarditis
Side effect of thiazide diurects
Increased urea absorption so increased risk of gout
Ureamic symptoms
Uraemic symptoms
Nausea, vomiting, weight loss
Neurological symptoms
Uraemic pericarditis (rarely seen in modern day practice)
