Pathophysiology of Chronic Kidney Disease Flashcards
What is CKD
Decrease in GFR which occurs over months/years
often irreversible
What are symptoms of abnormal kidney function
Fatigue breathlessness leg swelling nausea/anorexia, weight loss, itch bone pain
What are signs of abnormal kidney function
Pallor
Oedema
hypertension
Proteinuria/haematuria
What are causes of CKD
Diabetic kidney disease
hypertensive and/or atherosclerotic vascular disease of the kidney
Glomerulonephritis
Polycystic kidney disease
What is the pathology of diabetic nephropathy
Hyperglycaemia - mesangial expansion
- glomerular basement membrane thickening
What causes interglomerular hypertension
Glomerular sclerosis
What are the consequences of reduced eGFR
fluid retention
Decreased metabolic excretion
What are features of drug prescribing in renal disease
Low GFR- prolongs the half-life of many drugs leading to increase in risk of drug toxicity
some drugs can make kidney failure worse by distributing renal physiology
What are the consequences of a decrease in renal tubular function
Decrease in fluid reabsorption
Decrease in potassium excretion
Decrease acid secretion and decrease in bicarb formation
When might renal bone disease occur
decrease in vit D activation because of kidney damage
decrease in Ca absorption from the gut
decrease in mineralisation of bone ( osteomalacia)
hyperparathyroidism
How do we manage CKD
Treat hypertension
slow progression of proteinuria renal diseases with ACEi/ARB
decrease in associated CV risk
What are used for renal replacement therapies for end stage renal disease
Haemodialysis- hospital
peritoneal dialysis- Home
kidney transplant
