Week 11 - CKD Flashcards
What is the effect of chronic renal injury on tissue?
-Renal tissue is replaced by extracellular matrix leading to dibrosis and scarring
List some hereditary causes of CKD
- PCK
- Alport’s
What systemic diseases can lead to CKD?
- Diabetes mellitus
- Myeloma
What infection can lead to CKD?
-Pyelonephritis
What is the main immunologic cause of CKD?
-Glomerulonephritis
What common conditions can lead to CKD?
-Hypertension, diabetes, atherosclerosis
Name some risk factors for CKD
- Increasing age
- Ethnicity
- Low socio-economic status
What is the aim of treatment for CKD?
-attempt to dcrease the rate of decline of renal function
What three things do we measure to monitor CKD?
- Proteinuria
- Serum creatinine
- GFR
What is the significance of proteinuria in CKD?
-High proteinuria is associated with steeper decline
What determines serum creatinine levels?
-Renal function, muscle mass, age, sex and race
What is the difference between GFR and eGFR?
-eGFR tales into account age, sex and race
What are the aims of investigation into CKD?
-Define degree of impairment and cause to provide diagnosis and prognosis
People with CKD are at higher risk of what type of death?
-Cardiovascular
What are the effects of acidosis in CKD?
-Affects muscle, bone and renal function progression
What type of anaemia is seen in CKD and why?
-Anaemia of chronic disease and due to decreased EPO production
What is renal osteodystrophy?
-Alteration in bone morphology due to abnormalities in Ca, P, PTH or Vit D metabolism
Name some effects of renal osteodystrophy which occur in CKD
- Rugger jersey spine
- Osteitis fibrosa cystica
- Calciphalaxis
What is calciphylaxis?
-Vascular/soft tissue calcification of the skin leading to small areas of necrosis
List some potentially modifiable risk factors for CKD
- Smoking, obesity, lack of exercise
- Diabetes and high blood pressure
How do you measure the GFR in a hospital setting?
-Inulin or creatinine clearance
What investigations would you do to assess the cause of CKD?
- History and examination
- Autoantibody screen
- CRP
- Imagining of kidneys (USS, CT MRI)
What does a USS tell you in CKD?
- Size of kidney
- Presence of hydronephrosis
Describe the relationship between GFR and vitamin D
-Decreased GFR limits the delivery of substrate to a1-hydroxylase and thus causes a decrease in active vitamin D production despite PTH levels
Describe the indications for dialysis in CKD
- Uraemic symptoms
- Acidosis
- Pericarditis
- Fluid overload
- Hyperkalaemia
What is chronic kidney disease?
-The irreversible and sometimes progressive loss of renal function over a period of months to years
What are the effects of CKD histiologically?
- Glomerulosclerosis
- Tubular interstitial fibrosis
