Renal Flashcards
Definition of CKD
GFR<60 OR Kidney damage (protein in urine, abn urinary sediment, abn biopsy, abn imaging, electrolyte anomalies, hx of transplant) for 3 months
Definition of AKI
GFR<60 OR Kidney damage (protein in urine, abn urinary sediment, abn biopsy, abn imaging, electrolyte anomalies, hx of transplant) for LESS THAN 3 months
Stage I CKD
GFR >90
Stage 2 CKD
GFR 60-90
Stage 3a CKD
GFR 45-59
Stage 3b CKD
GFR 30-44
Stage 4 CKD
GFR 15-29
Stage 5 CKD
<15
How many adults are affected by CKD in the US
15%, 1/7, about 37 million
Major CKD risk factors
DM, HTN, CVD, AKI
Most common etiology of CKD
DM or HTN
Clinical presentation of CKD
Edema, HTN, decreased urine output, proteinuria(foamy), hematuria, uremia, pericardial friction rub, uremic frost
Most important diagnostic tests for CKD pts
eGFR, urine albumin-to-creatinine ratio, urinalysis
limitations of eGFR
not reliable when >60, in AKI, if pt <18
renal U/S findings for CKD
atrophic or small kidneys, cortical thinning, increased echogenicity, elevated resistive indices
Change in kidney function with age
GFR declines by 1ml/min/yr after 30-40
Common complications of CKD
CVD, mineral and bone disease (hypocalcemia-> secondary hyperparathyroidism), anemia, electrolyte abnormalities, HTN, uremia
Indications for dialysis
A: severe Acidosis E: Electrolyte disturbance I: Ingestion O: volume Overload U: Uremia
Definition of azotemia
elevated BUN without sxs
Definition of uremia
elevated BUN with sxs (N/V, confusion, pruritus, metallic taste in mouth, fatigue, anorexia)
AKI diagnosis is based on
serum creatinine and urine output
State 1 AKI
1.5-1.9x baseline creatinine, urine output <0.5L for 6-12 hours
Stage 2 AKI
2-2.9x baseline creatinine, UO < 0.5ml for >12 hours
Stage 3 AKI
3x baseline Cr, UO < 0.3 for >24 hours
