Kidney disease Flashcards
ESRD- End Stage Renal Dz
defined as GFR < 15
ESRD
person has irreversible kidney fx loss and is dependent on dialysis or transplant
Most common causes of CKD
Diabetes
Hypertension
Glomerulonephritis
Normal GFR
b/w 90 and 120
Stage 1 of CKD: still have normal GFR (meaning over 90), BUT
with signs of kidney dz like:
proteinuria, hematuria, abnormal renal structure
Stage 5 CKD
GFR < 15 OR
reliant on Dialysis
What imaging is recommended in all pts with CKD?
Renal Ultrasound
and microscopic eval of Urine
Common conditions associated with CKD
Anemia
Hyperphosphatemia
not enough blood, too much phosphate
Hyperphosphatemia (often caused by CKD)
Signs and sx result from low Ca levels
muscle cramps tetany numbness/tingling around mouth joint pain pruritis rash
Tx for hyperphosphatemia
Phosphate binders
What things reduce Kidney blood flow? (Renal perfusion)
Hypovolemia
Hypotension
Infection
Drugs that lower GFR
Treating HTN in pts with CKD
Start with ACE-I or ARB
THEN,
add CCB or Thiazide prn
Vaccinations to consider in pts with CKD
Flu
Pneumococcal
Hep B
Small kidneys on imaging reflect
irreversible disease
rarely should be biopsied. because result will not alter tx of prognosis of the condition
in pretty bad shape
Most important measure in prevention of ESRD
Glycemic control
