Complications of CKD Flashcards
What are the complications of CKD?
Accumulation of waste products
Salt and water retention
High blood pressure
Metabolic acidosis
Hormone disturbaces
Examples of hormonal disturbances triggered by CKD
Secondary hyperparathyroidism
Bone disease
Why does fluid accumulate in CKD?
The ability for the tubule to filter water and sodium breaks down
Water and salt retention leads to fluid accumulation
What are clinical ways to pick up fluid accumulation?
Press on skin - leaves dent due to presence of water
Pulmonary oedema - can hear crackles via stethoscope
How does CKD affect blood pressure?
CKD leads to secondary hypertension
Secondary hypertension causes more kidney injury
What causes secondary hypertension in CKD?
Fluid retention
Activation of the renin-angiotensin system
Excess renin production
Increased sympathetic activity
What are the consequences of hypertension?
Left ventricular hypertrophy
Heart failure - many patients with CKD die from heart failure rather than kidney failure
What is metabolic acidosis?
When kidney are not removing enough acids from the body, so there is a build up of acid in the blood
Why does CKD lead to metabolic acidosis?
There is diminished excretion of non-volatile acids
Increased loss of bicarbonate ions
What do patients with metabolic acidosis present wit clinically?
Hyperventilation
To remove the carbon dioxide from the system - pushes to form less carbonic acid
Which hormones do kidneys control?
EPO
Vitamin D
What stimulates EPO production from the kidney?
Decreased blood oxygen
What is the role of EPO?
Acts in the bone marrrow to increase numbers of RBC precursors
What happens to EPO production during CKD?
EPO concentration decreases
There is less RBC precursor production
Less RBC in the blood
What condition stems from the decreased EPO synthesis?
Normochromic normocytic anaemia