CKD

Question 1

chronic kidney disease

Answer 1

• nonreversible destruction of both kidneys
• nonfunctional scar tissue replaces destroyed nephrons
• up to 80% of GFR may be lost
• GFR

Question 2

main causes of CKD

Answer 2

• diabetes

- HTN

Question 3

uremia in CKD

Answer 3

• kidney function declines to the point that symptoms occur in multiple body systems
• often underdog and undertx d/t frequently asymptomatic
• often occurs when GFR

Question 4

urinary s/s

Answer 4

• polyuria: usually d/t DM
• early stages: no changes in UO
• SG 1.010
• anuria when pt on dialysis

Question 5

metabolic s/s

Answer 5

• waste product accumulation
• BUN/Cr increase
• impaired glucose sensitivity (need extremely high doses of insulin)
• elevated triglycerides

Question 6

electrolytes and acid base s/s

Answer 6

• hyperkalemia
• hyponatremia
• hyperMg: hard to dialysize out
• metabolic acidosis

Question 7

hematologic s/s

Answer 7

• anemia
• bleeding tendencies d/t defective platelets
• infection
• increased incidence of Ca

Question 8

CV s/s

Answer 8

• HTN
• accelerated atherosclerosis
• MI
• stroke
• CHF
• cardiac dysrhythmias
• uremia pericarditis (non radiating CP)

Question 9

most common cause of death in pts with CKD

Answer 9

CV disease

Question 10

respiratory s/s

Answer 10

• kussmaul’s
• dyspnea
• pulmonary edema
• uremia pleuritis
• pleural effusion
• uremia lung

Question 11

GI s/s

Answer 11

• gastritis
• mucosal ulcerations
• stomatitis
• gastroparesis
• GI bleed
• diarrhea/constipation

Question 12

neurological s/s

Answer 12

• CNS depression
• sz
• HTN encephalopathy
• dialysis encephalopathy
• peripheral neuropathy

Question 13

musculoskeletal s/s

Answer 13

• CKD-mineral and bone disorder
• osteomalacia
• osteitis fibrosa
• vascular wall calcification
• intracardiac calfication

Question 14

CKD mineral and bone disorder

Answer 14

• as kidney function deteriorates, less it D is converted to the active form
• which leads to decreased Ca absorption from the intestines

Question 15

integumentary s/s

Answer 15

• yellow-gray discoloration
• pruritus
• uremic frost
• petechiae
• ecchymoses
• dry brittle hair and nails

Question 16

reproductive s/s

Answer 16

• infertility
• decreased libido
• sexual dysfunction
• menses and ovulation may return after dialysis
• neuropathy can cause impotence and anorgasmy