Session 7- Chronic Kidney Disease

Question 1

how does CKD affect the structure of the kidney

Answer 1

thinning of cortex where nephrons are

shrinking of cortex

Question 2

what are the main causes of CKD

Answer 2

diabete s

hypertension

Question 3

modifiable risk factors of CKD

Answer 3

smoking
weight
lack of exercise
lifestyle

Question 4

water handling in CKD

Answer 4

lose ability to maximally dilate and concentrat urine

small GFR but same solute load causes osmotic dieuresis …. nocturia

Question 5

how do we treat acidosis

Answer 5

oral NaHCO3

Question 6

when can hyperkalaemia develop secondary and what can we do abiut it

Answer 6

when eGFR <20 mls/ min

stop ACE-Inhibitor/ angiotensin receptor bloker

avoidance of other drugs that can increase K+

alter diet to avoid food with high potassium

Question 7

what is crucial when treating anaemia in CKD

Answer 7

check iron levels first then re check Hb if still low start EPO stimulaing agent

Question 8

how does CKD cause bone mineral disease

Answer 8

decreased activated Vit D

decreased Ca2+ absorption from gut

reduced plasma Ca2+

stimulation of PT glands therefore PTH

increased osteoclast activity and hence bone resorption

impaired minerlisation of bone

Question 9

how can we maintain bone density in CKD

Answer 9

reduce phosphate intake
phosphate binders
vitamin D

Question 10

symptoms of end stage renal disease

Answer 10

tiredness
difficulty sleeping
difficulty concentrating
nausea and vomiting 
restless leg 
pruritis