CKD - Overview

Question 1

Levels of GFR x_x

GFR stages

Answer 1

• G1: >90
• G2: 60-89
• G3a: 45-59
• G3b: 30-44
• G4: 15-29
• G5: <15, kidney failure

Question 2

levels of albuminuria x_x

Answer 2

A1: normal -mildly increased: < 30 mg/g / < 3mg/mmol
A2: 30-300mg/g
A3: > 300 mg / g

Question 3

Causes of CKD

Answer 3

• DM, Glomerulonephritis, HTN, chronic infections, drugs, urinary obstruction, genetic disorders (polycystic kidney disease

Question 4

Clinical presentation of CKD

Answer 4

• Uremic symptoms: fatigue, weakness, SOB, mental confusion, N&V, bleeding, loss of appetite, itching, cold intolerance, weight gain, neuropathy, uremic breath
• Signs: edema, changes in urine output, abdominal distension, pericardial rub, asterixis (flapping hands)

Question 5

Lab abnormalities of CKD

Answer 5

• Increased SCr, urea, K, P, PTH, BP, glucose, lipids, Ca (if on Vit D therapy)
• Decreased GFR, CrCl, CO2, Hgb, Fe, 25(OH)D, albumin, Ca (early stages of CKD), HDL

Question 6

Goals in CKD management

Answer 6

• Slow down disease progression & delay need for RRT
• Maintain fluid and electrolyte homeostasis
• Provide adequate nutritional and metabolic support
• Prevent and treat extrarenal complications
• Reduce morbidity and mortality

Question 7

risk factors for cvd in ckd

Answer 7

• Age, male, smoking, DM, HTN, dyslipidemia
• Malnutrition, uremic toxins, inflammation (increased CRP, IL-6), oxidative stress, vascular calcification (due to increased Ca, P, PTH)