LEC 4: Chronic Kidney Disease (CKD) Flashcards Preview

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Flashcards in LEC 4: Chronic Kidney Disease (CKD) Deck (21)
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1
Q

What is the function of the kidneys?

A
  • Filter waste products from the bloodstream
  • Maintain fluid, electrolytes, and acid-base balance in the body
  • Excrete metabolic waste products
2
Q

What is the secondary function of the kidneys?

A
  • Regulate blood pressure
  • Facilitate bone density by calcitriol that helps create vitamin D
  • Regulates bone density
  • Stimulates bone marrow to produce RBC by erythropoietin
3
Q

Glomerular Filtration Rate (eGFR)

A
  • The volume of blood filtered by the glomeruli in one minute
  • Deviations indicate impaired renal function
  • Normally about 125 mL/min per glomeruli
  • Can be estimated based by serum creatinine measurement

*Abnormal levels means kidneys are not functioning

4
Q

What is chronic kidney disease (CKD)?

A
  • Progressive, irreversible, loss of kidney function
  • Loss of nephrons
  • GFR is less than 60 mL/min for 3 months or longer
  • Damages ranges from stages 1 to 5
  • Early stages usually undetectable
  • Stage 5 is the end stage for renal disease
5
Q

When will you start to see GFR symptoms?

A

Will not have GFR symptoms until stage 4

*More than 75% of the nephrons have to be damaged for symptoms to occur

6
Q

What percentage of nephrons need to be damaged for symptoms to occur?

A

More than 75% of the nephrons have to be damaged for symptoms to occur

7
Q

What are the clinical manifestations of Uremia?

A
  • Psychological changes
  • Cardiovascular system
  • Gastrointestinal system
  • Reproductive system
  • Metabolic disturbances
  • Hematological system
  • Neurological system
  • Respiratory system
  • Integumentary system
  • Urinary system
  • Electrolytes disturbances
  • Musculoskeletal system

*Substances are being retained and every body system is affected

8
Q

Uremia

A

An excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be normally excreted in the urine. Is the terminal clinical manifestation of kidney failure.

9
Q

How does uremia occur?

A

Results from build up of waster products and excess fluid associated with kidney failure
- Start to see in stage 4 and 5 of GFR

10
Q

Uremia: Psychological Changes

A
  • Anxiety

- Depression

11
Q

Uremia: Cardiovascular System

A
  • Hypertension
  • Heart failure
  • Coronary artery disease
  • Pericarditis
  • Peripheral artery disease
12
Q

Uremia: Gastrointestinal System

A
  • Anorexia
  • Nausea
  • Vomiting
  • Gastrointestinal bleeding
  • Gastritis
13
Q

Uremia: Endocrine/ Reproductive System

A
  • Hyperparathyroidism
  • Thyroid abnormalities
  • Amenorrhea
  • Erectile dysfunction
14
Q

Uremia: Metabolic Disturbances

A
  • Carbohydrate intolerence

- Hyperlipidemia

15
Q

Uremia: Hematological System

A
  • Anemia
  • Bleeding
  • Infection
16
Q

Uremia: Neurological System

A
  • Fatigue
  • Headache
  • Sleep disturbances
  • Encephalopathy
17
Q

Uremia: Respiratory System

A
  • Pulmonary edema
  • Uremic pleuritis
  • Pneumonia
18
Q

Uremia: Integumentary System

A
  • Pruritus
  • Ecchymosis
  • Dry, scaly skin
19
Q

Uremia: Musculoskeletal System

A
  • Vascular and soft tissue calcification
  • Osteomalacia
  • Osteitis fibrosa
20
Q

Diagnostic Tests

A
  1. Early detection and treatment is key
  2. Urine tests
    - Proteinuria: urine protein to creatine or albumin to creatine
    - Urinalysis
  3. eGFR, serum creatine
  4. Ultrasound, Biposy, CT scan
  5. Serum: CBC, calcium, phosphate, albumin, parathyroid hormone levels
21
Q

How does proteinuria diagnostic test help with CKD ditection?

A

Normal function of kidneys keep protein. If kidneys are damaged there will be holes and protein will leak out into the blood stream
- Will have protein in blood stream