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REN > L11: Chronic Kidney Disease > Flashcards

L11: Chronic Kidney Disease Flashcards

1
Q

What are the 3 main functions of the kidney

A

Homeostasis
Endocrine
Excretion of drugs

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2
Q

What happens to the creatinine concentration when kidney function gets worse

A

Creatinine increases

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3
Q

What happens to the creatinine levels when kidney function improves

A

Kidney function gets better

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4
Q

Why is measuring creatinine levels alone not reliable

A

When kidney function reduced from 100% to 50% creatinine levels can show to be normal when in-fact kidney function is declining

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5
Q

Instead of measuring creatinine levels what do we measure instead

A

Estimated GFR

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6
Q

What does the estimated GFR consider

A

Age
Ethnicity
Creatinine

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7
Q

What is the normal range for estimated GFR

A

Above 90

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8
Q

What is the definition of chronic kidney disease

A

Estimated GFR less than 60ml/min/1.73m2

Or kidney damage that has been present less than 3 months

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9
Q

Is chronic kidney disease reversible

A

No it is irreversible

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10
Q

How many stages of chronic kidney disease is there

A

5

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11
Q

Which stage is the worst chronic kidney disease

A

Stage 5

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12
Q

What is stage 5 chronic kidney disease also known as

A

Renal failure

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13
Q

What happens to the estimated GFR as stages of chronic kidney disease increase

A

Estimated GFR decreases

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14
Q

In renal failure what type of treatment does the patient require

A

Dialysis: peritoneal or haemodialysis

Transplantation

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15
Q

What are the categories of causes of developing chronic kidney disease

A 
Systemic disease
Immune mediated disease
Infectious disease 
Genetic 
Arterial disease 
Obstruction
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16
Q

What does systemic disease include

A

Hypertension

Diabetes

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17
Q

What doe immune mediated disease involve

A

Membranous nephropathy

IGA nephropathy

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18
Q

What does infectious disease involve

A

HIV
HBV
TB
HCV

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19
Q

What does genetic disease involve

A

Polycystic disease

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20
Q

What does arterial disease involve

A

Artheroscelorisis

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21
Q

What does obstruction involve

A

Stones
Tumours
Fibrosis

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22
Q

When patient have diabetes what pathological changes can occur in the kidney to cause chronic kidney disease

A

Basement membrane of glomerulus thickens

Mesangial cells multiply

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23
Q

When obstruction occur

A

Stones
Tumours : inside or outside
Fibrosis
Benign prostate

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24
Q

What can the failure of fluid homeostasis lead to

A

Oedema

Inability to concentrate urine

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25
What is the treatment for fluid overload
Diuretics Restrict salt Restrict fluid intake Dialysis or transplant (if everything fails)
26
What happens to the secretion of sodium in CKD
Decreases
27
What does reduction in salt secretion lead to
Hypertension | Fluid overload
28
Why do we get hyponatraemia
Water dilutes the salt
29
What is the treatment of hyponatraemia
Reduced salt intake | Dialysis or transplant
30
What happens to potassium secretion in CKD
Decreases
31
What does a build up of potassium lead to
Hyperkalaemia
32
What can hyperkalaemia lead to
Cardiac arrhythmia
33
What is the treatment for hyperkalaemia
Restrict potassium in diet | Dialysis or transplant (If it fails)
34
What happens to hydrogen secretion in CKD
Decreases
35
What does reduced secretion in CKD lead to
Metabolic acidosis
36
How is metabolic acidosis compensated
Hyperventilation
37
What is the treatment for metabolic acidosis
Reduce hydrogren ingestion Sodium bicarbonate Dialysis or transplant (if everything else fails)
38
Which 3 hormones are produced by the kidney
EPO Renin Active vitamin D
39
What is the role of active vitamin D
Increase calcium and phosphate reabsorption from the gut
40
Which organ in the body detect low calcium
Parathyroid gland
41
What hormone does the parathyroid gland secrete when it detects low calcium
PTH
42
What does PTH act on
Kidney | Bone
43
What happens to the kidney
Converts inactive vitamin d to active vitamin D
44
What does active vitamin D do to bring levels of calcium back up
Increase the reabsorption of calcium and phosphate from the gut
45
What happens to the level of PTH when calcium levels rise
PTH is switched off via a negative feedback
46
When the kidney doesn’t work i.e we do not get vitamin d to absorb calcium from the gut what happens to the PTH levels
Rise
47
What does high levels of PTH lead to
Hyperparathyroidism
48
What does high levels of PTH cause the bone to do
Turn over and release calcium
49
What is the treatment for bone disease and calcification
``` Give vitamin d analogues Phosphate binders Calcium supplement Phosphate restriction Remove parathyroid gland ```
50
What is EPO involved in
The production of RBC in the bone marrow
51
In which condition is EPO released from the kidney
Hypoxia
52
What is the treatment for renal anaemia
Give EPO
53
Does hypertension cause CKD
Yes
54
Is hypertension also a consequence in CKD
Yes
55
When can hypertension occur
``` Sodium retention Volume overload RAAS activation SNS activity Endothelial dysfunction ```
56
What is the treatment for hypertension
``` Decrease salt intake Decrease fluid intake Anti hypertensives Diuretics RAAS blockade drugs ```
57
What is the treatment of uraemia
Dialysis or transplant
58
Why do we not do protein restriction as a method of treatment for uraemia
Protein restriction can lead to malnutrition
59
In CKD what can happen to drug excretion
Decrease
60
What does a decrease in drug excretion lead to
Drugs accumulating and giving drug toxicity
61
How can we prevent drug toxicity
Reduce the dose of the drug

REN (19 decks)

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