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Urology > Lecture 15 Chronic Kidney Disease > Flashcards

Lecture 15 Chronic Kidney Disease Flashcards

1
Q

What things are assessed in kidney disease

A

Excretion
Barrier
Anatomy

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2
Q

Creatinine levels depend on__

A 
–	Age
–	Ethnicity
–	Gender
–	Weight
–	Liver disease- low
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3
Q

What is stage 1 CKD

A

Normal or high GFR

>90

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4
Q

What is stage 2 CKD

A

Mild reduction in GFR

60-89

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5
Q

What is stage 3a CKD

A

Moderately impaired

GFR 45-59

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6
Q

What is stage 3b CKD

A

Moderately impaired

GFR 30-44

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7
Q

What is stage 4 of CKD

A

Severely impaired

GFR 15-29

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8
Q

What components cross the GBM

A
  • Water
  • Electrolytes
  • Urea
  • Creatinine
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9
Q

What components cross the GBM but are reabsorbed in the PCT

A
  • Glucose

* Lower molecular weight proteins (O2 microglobulin)

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10
Q

What components do not cross the GBM

A
  • Cells (WBC, RBC)

* High molecular weight proteins (albumin, globulin)

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11
Q

What other tests can be done to assess kidney function

A 
•	Urinalysis 
–	Blood
–	Protein
•	Protein quantification
–	Protein creatinine ration (PCR)
–	Albumin creatinine ratio
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12
Q

Name aetiologies of CKD

A
  • Diabetes
  • Glomerulonephritis
  • Hypertension
  • Renovascular disease
  • Polycystic kidney disease
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13
Q

What are the symptom and signs of CKD

A
  • Pallor secondary to anaemia
  • Hypertension
  • SOB
  • Itch and cramps
  • Cognitive changes
  • Change in urine output
  • Haematuria
  • Proteinuria
  • Peripheral oedema
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14
Q

What tests can be done to diagnose kidney disease

A 
•	U&Es
•	FBC- anaemia
•	Urine dip
•	Urine PCR (24-hour collection)
•	Renal bx
Ultrasound
Biochemistry
Coagulaiton screen
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15
Q

How is CKD managed

A
  • Blood pressure- most important
  • Control proteinuria (ACIE, ARB)
  • Treat underlying cause
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16
Q 
How are these complications related to reduced GFR managed :
•	Acidosis- 
•	Anaemia- 
•	Bone disease-
•	CV risk-
•	Death & Dialysis- 
•	Electrolytes-
•	Fluid overload- 
•	Gout- 
•	Hypertension- s
•	Iatrogenic issues
•	Trimethoprim-
A
  • Acidosis- bicarbonate
  • Anaemia- EPO and iron
  • Bone disease- diet and phosphate binders
  • CV risk- BP, aspirin, cholesterol, exercise, weight
  • Death & Dialysis- counsel and prep
  • Electrolytes- diet and consider drugs
  • Fluid overload- salt and fluid restrictions, diuretics
  • Gout- optimise, meds
  • Hypertension- weight, diet, fluid balance, drugs
  • Iatrogenic issues
  • Trimethoprim- can increased potassium  hyperkalaemia
17
Q

What is the preparation for end stage renal disease and renal replacement therapy

A
  • Education & information
  • Selection of modality- HD / PD ?transplant ??conservative care
  • Planning access
  • Deciding when to start RRT
  • Multidisciplinary team

Urology (26 decks)

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