The Burden of Chronic Kidney Disease in Indigenous Australians

Question 1

What does the kidney do?

Answer 1

WASH

W - waste

A - acid base

S - Salt/water

H - Hormones

Question 2

How do you determine the eGFR?

Answer 2

Serum creatinine equated with a number of other factors eg weight, height, ethnicity

Question 3

What is the cut of a normal eGFR?

Answer 3

>90 is normal

Question 4

What is the normal size of the kidney?

Answer 4

12cm

Question 5

What might you expect when USing a diabetic kidney?

Answer 5

Enlarged at first to deal with the higher glucose load

Then smaller if failing

Question 6

How can you interrogate the kidney function?

Answer 6

Bloods - Creatinine, eGFR

Urine - Albuminuria, haematuria

US - Size

Biopsy

Question 7

How do ACEi protect the kidneys?

Answer 7

Lower blood pressure

Block angiotensin’s tonic vasoconstriction of efferent arterioles to reduce glomerular hypertension/hyperfiltration

Question 8

What are some factors that contribute to the higher prevalence of kidney disease in indigenous people?

Answer 8

Low birth weight

Poor nutrition

Education

Obesity

Diabetes

Smoking

Infection

Question 9

How does fat distribution differ in Indigenous people?

Answer 9

Greater central adiposity

Question 10

How does increased infections related to CKD?

Answer 10

More infections > More post strep GN > Scarring > Hypertension

Question 11

How does low birth weight relate to kidney disease?

Answer 11

Low birth weight = Less nephrons

Question 12

Physiologically, how does kidney damage exascerbate HTN?

Answer 12

Kidney produces renin > Increases BP > More kidney damage

Question 13

What constitutes a basic kidney health check?

Answer 13

BP

UEC

Urinalysis - Albumin/Creatinine ration (ACR)

Question 14

At which stage of CKD might you expect EPO deficiency?

Answer 14

3b