Renal failure

Question 1

What are 3 things secreted by the kidneys? What do each of them do?

Answer 1

renin - regulate bp
EPO - regulare RBC production
vit D - regulate calcium uptake

Question 2

What is the clinical definition of CKD?

Answer 2

GFR < 60ml/min per 1.73m^2 per body surface area. Presence of kidney damage for 3 or more months

Question 3

Define GFR

Answer 3

Sum of all nephron filtration rates as an idea of overall excretory function

Question 4

For stage 1 and 2 CKD, what other things you need, and why for classification of CKD?

Answer 4

abnormal urinalysis eg proteinuria or blood in urine

Question 5

What are some risk factors for CKD? Max 8

Answer 5

diabetes
high bp
age >60 yrs
smoking
obesity 
family history
ethnic minorities 
established CVD

Question 6

What are some clinical presentations of CKD? Max 7

Answer 6

serum abnormality 
proteinuria/haematuria
hypertension
oedema 
symptoms of primary renal disease
symptoms of uraemia (high urea conc) 
complications of CKD

Question 7

List a few symptoms of renal failure

Answer 7

tiredness/fatigue (renal anaemia)
oedema/hypertension/SoB (salt and water retension)
itching (uraemia, phosphate retention)

Question 8

What are 2 things to look for in a urine dipstick that point towards renal disease?

Answer 8

proteinuria and haematuria

Question 9

List some factors for progression of CKD

Answer 9

hypertension
proteinuria
dyslipidaemia (abnormal blood lipid levels)
smoking
age
gender (male>female)
race
diabetes control

Question 10

List some modifiable risk factors of CKD max 5

Answer 10

lifestyle (smoking, nutrition, alcohol)
treat diabetes
lowering bp
lower proteinuria (ACEi)
lipid lowering drugs

Question 11

What are 4 differentials for oedema

Answer 11

heart failure
renal failure
liver failure
hypoalbuminaemia

Question 12

How is AKI different to CKD?

Answer 12

abrupt/rapid decline in kidney function
GFR is reduced
occurs in response to other insults

Question 13

What are some ways to detect AKI?

Answer 13

rise in serum creatinine conc
fall in urine output
uraemia

Question 14

What are the 3 broad categories of AKI cause classification?

Answer 14

Pre-renal
Intrinsic
post-renal

Question 15

What are the common causes of
Pre-renal AKI
Intrinsic slide
Post renal

Answer 15

pre-renal - dehydration, hemorrhage, decreased cardiac output, congestive heart failure/infarct, systemic vasodilation, anaphylactic shock/sepsis)
intrinsic - renal disease, toxins
post renal- obstruction of flow of urine