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Chronic Kidney Disease Notes

Medicine Notes > Renal System Notes

This is an extract of our Chronic Kidney Disease document, which we sell as part of our Renal System Notes collection written by the top tier of Bristol University students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Renal System Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Lecture 17 Chronic Kidney Disease





Definition o Renal failure
? In essence

* Decreased renal excretory function

* Decreased GFR

* Raised serum creatinine and urea
? Chronic or acute
? Chronic= weeks or months, often IRREVERSIBLE
? Acute= days or weeks, maybe/often REVERSIBLE o Chronic Kidney Disease
? Evidence of structural or functional kidney abnormalities (abnormal urinalysis, imaging studies, or histology)
? Persist for >3/12 months
? Decreased GFR
? Most common manifestation of damage is persistent albuminuria
? Failure of

* Glomerular filtration

* Tubular handling of solute

* Erythropoietin production

* Activation of vitamin D

* Blood pressure regulation Classification o Numbered 1-5 (5=most severe) o Works on GFR function o 1= kidney damage with normal or increased GFR o 5=Established renal failure, GFR <15 Symptoms and signs o Symptoms
? Often asymptomatic
? Vague (nausea, loss of appetite, itching etc.)
? Fluid overload (swelling, SOB)
? Anaemia (tired, SOB, angina)
? Urinary symptoms (nocturia, frequency)
? Symptoms related to underlying disease o Clinical signs
? Often non-specific
? Skin (pallor, pruritus marks, rashes)
? CV (high BP, raised JVP, 3rd heart sound, pericardial rub, peripheral oedema)
? Respiratory (Tachypnoea, crepitations)
? Abdominal (ascites, scars) Causes o PRE-RENAL
? Usually to do with blood supply
? Decreased CO
? Renovascular occlusion (renal artery stenosis, aortic aneurysm/dissection)
? Impaired renal autoregulation (NSAIDs, cyclosporin, ACEis) o INTRA-RENAL

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