Describe the pathophysiology, clinical manifestations, and evaluation of chronic kidney disease (CKD)

Question 1

Pathophysiology:

Answer 1

o Glomerular hypertension, hyperfiltration, and hypertrophy
o Glomerulosclerosis
o Tubulointerstitial inflammation and fibrosis

Question 2

Clinical Manifestations:

Answer 2

o Creatinine and urea clearance
o GFR falls
o Plasma creatinine increases
· Fluid and electrolyte balance
o Sodium and water balance
o Potassium balance
o Acid-base balance (kidneys and respiratory system)
o Metabolic acidosis most likely to develop when DFR is less than 25% normal level
· Calcium, phosphate, bone
o Reduced renal phosphate excretion, decreased renal synthesis of 1,25-(OH)2 vitamin D3, and hypocalcemia.
o D is needed to process calcium
o Fractures
· Protein, carbohydrate, fat metabolism
o High LDL, decreased HDL, triglycerides are elevated
o Anemia
o Lethargy, dizziness, and low hematocrit are common
o Kidneys responsible for erythropoietin

Question 3

Evaluation:

Answer 3

ultrasound, ct scan, or plain x-rays will show a small kidney size. However, renal biopsy confirms the dianosis