Lecture 14- Chronic Kidney disease and cardiovascular risk Flashcards
4 main functions of the kidneys
excretory function
homeostatic function
endocrine function
metabolic function
what is CKD?
gradual loss of kidney function over time (months/years) related to disease/disorder/damage to kidneys (irreversible)
what is acute kidney injury?
sudden episode of kidney injury which occurs over hours/days (potentially reversible)
CKD defined as?
- lost more than half of kidney function (GFR) with or w/o evidence of kidney damage OR
- normal/abnormal GFR but have evidence of kidney damage e.g. proteinuria
what is the measure for kidney function?
GFR
stages 1 and 2 of CKD
kidney damage with normal kidney function
stages 3 and 4 of CKD
reduced kidney function (moderate and severe)
what stage causes the most problem? higher prevalence?
stage 3
stage 5 CKD
kidney failure
implications for kidney function at age 80
CKD is a disease of ageing
- therefore kidney function usually declines as you get older
- if no other factors for kidney damage present, then not CKD
people at risk of CKD
> 60
family history
have DM, high BP, established CVD
overweight, smoker, indigenous
2 most common causes of CKD
-diabetic nephropathy
renovascular -disease/hypertensive nephrosclerosis
3 less common causes of CKD
- reflux nephropathy- congenital problems (reflex of urine from bladder into kidney, scarring/fibrosis in kidney)
- glomerulonephritis - intrinsic kidney disease
- genetic renal disorders (PCKD)
3 tests for detection of CKD
BP
dipstick for proteinuria- early marker of kidney disease even when normal kidney function
eGFR
why is it important to do all 3 tests?
to maximise likelihood of CKD detection as there is variable overlap of indicators of kidney damage
is CKD asymptomatic?
yes- only start to feel non-specific symptoms (tired, unwell, itchy etc) when kidney function is 10-15%
how to manage aspects of CKD to slow deterioration in kidney function?
detect people earlier than symptomatic stage, can effectively intervene
-BP control, certain medication, reduce proteinuria will reduce natural progression of disease