HD 1- Chronic renal disease

Question 1

Normal volume production of urine a day?

Answer 1

1.5L

Question 2

Normal GFR?

Answer 2

125 ml/min

Question 3

A few methods used to assess GFR?

Answer 3

o Creatinine clearance
o Plasma creatinine concentration
o Estimation Equation e.g. Cockroft - Gault, MDRD – gives an estimated or eGFR

Question 4

Normal values of creatinine and what happens if creatinine levels increase?

Answer 4

o 95 +/- 20 mL/min in females
o 120 +/- 25 mL/min in males

GREAT decrease in GFR, will need dialysis

Question 5

How many stages are there in CKD?

Answer 5

5 stages.

1 is normal kidney function >90 GFR
5 is end stage kidney failure <15 GFR NEEDS dialysis

Question 6

Signs of chronic renal failure?

Answer 6

Tiredness
Pale
Unwell
Anorexic
Nausea/vomiting
Confusion
Uraemia

Question 7

Main effects of CRF?

Answer 7

Severe metabolic acidosis plus hyperkalaemia (more potassium) plus
An hypocalcaemia (less calcium) = increase cardiac instability (kidney gets rid of potassium)

Salt and water retention = peripheral and pulmonary oedema

Cramps, tremor, twitches, restless legs & hormonal imbalance

Question 8

Complications of dialysis?

Answer 8

Infection
Anaemia
Increased risk of heart disease
Cramps

Question 9

What dialysis patients need antibiotic prophylaxsis?

Answer 9

Haemodialysis or tx patients with a prosthetic valve or other endocarditis risk DO require prophylaxis.

3g oral amoxycillin or IV vancomycin.

Normal dialysis patients do not require antibiotic prophylaxis.

Question 10

Current renal transplant immunosuppression therapy?

Answer 10

Induction with monoclonal antibody therapy IL2

Then triple therapy: prednisolone, azathioprine, tacrolimus

Question 11

Oral side affects of prednisolone?

Answer 11

Caries and gum hypertrophy.

Question 12

Oral abnormalities in Oral facial digital syndrome?

Answer 12

Cleft palate
Bifid tongue
Brachydactyly