Renal Flashcards
How can an anion gap be useful?
Establishing cause of a metabolic acidosis.
If normal - due to reduced alkali including renal tubular acidosis cause
If increased - due to increased acid e.g. metabolic cause (DKA, lactic)
What is the definition of CKD?
Kidney damage that persists for more than 3 months.
What are the classifications of CKD?
> 90 > 60 45-59 mild-mod 30-44 mod-sev <30 severe < 15 kidney failure
What are causes of CKD?
Diabetes HTN Glomerulonephritis Renovascular disease Polycystic kidney disease
What are complications of CKD?
CVD - no 1 mortality!! Anaemia (ACD) Mineral bone disease Secondary hyperparathyroidism Fluid overload Electrolyte disturbances Metabolic acidosis Uraemic pericarditis and encephalopathy
What is the BP target for patients with CKD?
140/90
DM or A:CR>70 130/80
What is the target Hba1c?
7% / 53 mmol/mol
What tests should be done to monitor CKD?
eGFR and urinary A:CR
FBC
Serum Ca, Phosphate, PTH
Why is an AV fistula used for dialysis?
Easy access
Creates high flow to prevent collapsing
What medications are given to renal transplant patients?
Corticosteroids - immunosuppression
Anti-metabolites - azathiprine, mycophenolate mofetil
Calcineurin inhibitors - tacrolimus, ciclosporin
What are the disadvantages of having renal transplant?
Must be suitable for op Long waiting time Operation risks Lifelong medication - side effects Risk of rejection Risk of malignancies Risk of infection
What is the mechanism leading to hypocalcaemia, raised phosphate and raised PTH in CKD?
decreasing kidney function has resulted in his kidneys not being able to convert enough vitamin D to its active form and they are also not able to adequately excrete phosphate. Due to this insoluble calcium phosphate forms, removing calcium from the circulation, which results in hypocalcaemia. The parathyroid glands detect this and secrete parathyroid hormone to try and raise serum calcium levels.
Secondary hyperparathyroidism - low calcium
