Renal Flashcards
What are the 5 complications for renal failure?
Potassium Fluid state Anaemia Bone density Uraemia
when are you classed with stage 5 CKD
when GFR less than 15 ml/min
How should you monitor CKD?
eGFR
main medication to help CKD
ACEi
if a patient talks about a sore throat and then getting kidney failure straight away.. what does this point to
IgA nephropathy
if a patient talks about a sore throat and then getting kidney failure 2 weeks later… what does this point to
Post-strep nephropathy
Which GNs are mostly nephrotic?
Minimal change
Focal sclerosing
Membranous
Which GNs are mostly nephritic?
crescent associated GN
IgA nephropathy
Post strep (diffuse proliferative)
Treatment of CKD with ACEi is contraindicated in
Bilateral renal artery stenosis
in severe CKD where fluid overload can be a problem - which drug should you use to treat them and why
high dose frusemide - because it needs to enter a functional renal tubule to exert its effect
how do you define chronic kidney disease
GFR less than 60ml/min for more than 3 months (microalbuminaemia, proteinuria, glomerular haematuria, pathological abnormality, anatomical abnormality)
2 main causes of CKD in Australia
Diabetic nephropathy
Glomerulonephritis
What percentage of body water is intracellular?
67%
What percentage of body water is interstitial?
22%
What percentage of body water is intravascular?
11%
If you give 3L of saline, where will it distribute to?
Extracellular space: 2L to interstitial and 1L intravascular
If you give 3L of 5% dextrose, where will it distribute to?
Equally between all spaces: 2L intracellular and 1L extracellular (666ml interstitial and 333ml intravascular)
If you lose 3L of fluid through diarrhoea, which compartments will lose the fluid?
Diarrhoea is sodium rich, thus all loses will be extracellular (2L interstitial and 1L intravascular)
If you lose 3L of fluid through fasting, which compartments will lose the fluid?
Equally between all spaces: 2L intracellular and 1L extracellular (666ml interstitial and 333ml intravascular)
eGFR is only accurate when…
Creatinine is in a steady state (if rising - overestimates, falling - underestimates)
How can you tell by a clinical test if AKI is glomerular in origin?
Haematuria with abnormal RBC morphology
If the urine is normal or pretty bland - what does it suggest as a cause of AKI?
pre-renal or acute tubular necrosis
how can you tell the difference between pre renal AKI and ATN?
pre renal AKI - concentrating ability still intact
Clues pointing to CKD over AKI
- pre existing illness
- DM, HTN, age, vascular disease
- small, echogenic kidneys by ultrasound
- endocrine abnormalities
