GU - Chronic Kidney Disease

Question 1

Defintion

Answer 1

eGFR < 15ml/min

Question 2

Aetiology

Answer 2

• Structural malformations
• Glomerulonephritis
• Hereditary nephropathies
• Systemic diseases

Question 3

Signs and symptoms

Answer 3

• Usually ASx until renal function falls < ⅓ of normal, often picked up on antenatal ultrasound
• Anorexia and lethargy
• Polydipsia and polyuria
• Faltering growth
• HTN
• Acute-on-chronic renal failure precipitated by infection/dehydration
• Incidental finding of proteinuria

Question 4

Treatment

Answer 4

• Sufficient feeding with good protein intake to maintain growth -> this can
  supplemented with NG/gastrostomy feeding if necessary
• Phosphate restriction and activated vit D to prevent renal osteodystrophy
• Bicarbonate supplements to prevent acidosis
• EPO to prevent anaemia
• Growth hormone
• Dialysis and transplantation if necessary