Session 11 Flashcards
What is CKD?
Progressive and irreversible loss of renal function over a period of months/years. Renal injury causes renal tissue to be replaced by extracellular matrix in response to tissue damage.
What are the causes of CKD?
Immunologic (glomerulonephritis), infection (pyelonephritis), hypertension, systemic disease (e.g. Diabetes), genetic, idiopathic (commonest)
What are the risks for CKD?
Age, female, multi morbid, ethnic minorities, socially disadvantaged
How is CKD staged?
Based on GFR and urine albumin to creatinine ratio
How is eGFR measured?
Serum creatinine that is corrected for age, gender and ethnicity
What are the investigations for CKD?
USS (size/hydronephrosis), CT, MRI, biopsy (if no obvious cause)
What are the complications of CKD?
Acidosis - can affect bone, muscle, and make renal function worse. Treat with NaCO3
Anaemia - reduced erythropoietin
Mineral and bone disorders - less vit. D, less Ca2+ (due to reduced phosphate excretion) -> hyperparathyroidism
Hypertension
What are modifiable risks in CKD?
Diabetes, lifestyle, BP, ACEi/ang II blockers in proteinuria
What is end stage renal failure?
When GFR drops to 8-10ml/min and dialysis/transplant are needed
What are the symptoms of CKD?
Fatigue, nausea (waste products), breathlessness (pul. oedema), sleep reversal, oedema, itching, aches (bone disease)
What are the advantages and disadvantages of haemodialysis?
+: less responsibility, days off
-: travel/waiting time, tied to designated slots, fluid and diet restriction, CV access problem
What are the advantages and disadvantages of peritoneal dialysis?
+: independence, allows motility, less dietary restriction
-: frequent exchanges, peritonitis, responsibility
What are the advantages and disadvantages of kidney transplantation?
+: freedom from dialysis, reduced mortality, increased quality of life
-: immunosuppressive drugs, limited supply, infection risk
