Systemic disease and their treatments

Question 1

Most common cause of renal failure in Uk

Answer 1

Diabetes

Question 2

1st sign of renal damage in diabetics

Answer 2

Microalbuminuria

Question 3

Pathogenesis of diabetes kidney disease

Answer 3

renal hypertrophy
inflammation
proteinuria
tubulo-interstitial fibrosis

Question 4

Treatment for diabetic kidney disease

Answer 4

Maintain tight glycaemic control (HbA1C<7)
Anti-HTs (ACEi, ARBs)
Lipid Control

Question 5

What is the final treatment for diabetic kidney disease?

Answer 5

Haemodialysis, Peritoneal dialysis, kidney transplant OR simultaneous kidney-pancreas replacement
Diabetic dialysis = poor prognosis

Question 6

Treatment for cardiac + vascular kidney disease

Answer 6

Statin
Anti-platelet
ACEi (contraindicated in bilateral renal artery stenosis)
INTERVENTION = Angioplasty +/- stenting

Question 7

What is myeloma?

Answer 7

Cancer of plasma cells (produce antibodies) > collect in bone marrow impairing production of normal blood cells > monoclonal production of paraprotein (causes renal dysfunction)

Question 8

Management of myeloma kidney disease?

Answer 8

Stop nephrotoxics
Manage hypercalcaemia
Chemo+stem cell transplant
Plasma exchange 
supportive (dialysis)