Renal Flashcards
What criteria do you need to diagnose someone with chronic kidney disease?
You need at least 2x eGFRs <60 and/or 2x albumin creatinine rations of 3 mg/mmol or more on at least 2x occasions separated by 90 days / 3 months
What should be the first line investigation of suspected renal colic in a pregnant woman?
USS KUB
What is the first line antihypertensive for those with CKD?
Choose of antihypertensive in CKD is influenced by whether they have an abnormal A:Cr or not.
If raised ACR: 1st line is ACE
If normal ACR / no proteinuria: 1st line is standard 1st line depending on age and ethnicity (so ACEi if <55 or diabetic of any age/ethnicity, Ca channel blocker if > 55 or afro-carribean)
Which patients with CKD require referral to a renal specialist?
a 5-year risk of needing renal replacement therapy of greater than 5% (measured using the 4-variable Kidney Failure Risk Equation)
an ACR of 70 mg/mmol or more, unless known to be caused by diabetes and already appropriately treated (see recommendations 1.6.6 and 1.6.7)
an ACR of more than 30 mg/mmol (ACR category A3), together with haematuria
a sustained decrease in eGFR of 25% or more and a change in eGFR category within 12 months
a sustained decrease in eGFR of 15 ml/min/1.73 m2 or more per year
hypertension that remains poorly controlled despite the use of at least 4 antihypertensive medicines at therapeutic doses
known or suspected rare or genetic causes of CKD
suspected renal artery stenosis
What is the most common cause of end stage renal failure in the UK?
Diabetes
