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Complex Multi-System "Chronic Kidney Disease", Systemic…
Complex Multi-System
"Chronic Kidney Disease"
Reduced nephron numbers
Angiotensin II
Inflammatory mediators (e.g., NF-kB and TGF-B)
Efferent arteriolar constriction
Interstitial hypoxia
Glomerular hypertension and hyperfiltration
Proteinuria
Tubular hypermetabolism
Generation of reactive oxygen species (ROS)
Glomerulosclerosis
Nephron destruction
Interstitial fibrosis
CKD is when the kidneys are damages and cannot filter blood properly
CKD has a glomerular filtration rate (GFR) below 60 mL /min
it happens slowly over a long period of time, known as "silent killer"
causes waste build up in the body
a GFR of 15 or less would result in renal failure
As it gets worse over a period of time it alters multi-organs and cross alterations on different body systems
The Blood System
The Cardio-Vascular System
The Integumentary System
The Skeletal System
The Joints
The Circadian System
The Nervous System
The Digestive System
The Immune System
Manifestations at later stages of CKD
Weight loss
poor appetite
swollen due to water retention
Edema
shortness of breath
insomnia
muscle cramps
itchy skin
dry skin
headaches
weak/tired
blood in urine
possible decrease in urine output
chest pain
nausea
vomiting
trouble concentrating or focusing
Diagnosis
blood test that checks how well the kidneys are filtering the blood in the body
called glomerular filtration rate (GFR)
Urinalysis
checking for albumin
urine albumin to creatinine ratio
Imaging test
CT or MRI
Sonography
can provide renal measurements and echogenicity
Stages of CKD and GFR for each
Stage 1
: with normal or high GFR (GFR >90 mL/min)
Stage 2
: mild CKD (GFR = 60-89 mL/min)
Stage 3A
: moderate CKD (GFR = 45-59 mL/min)
Stage 3B
: moderate CKD (GFR = 30-44 mL/min)
Stage 4
: severe CKD (GFR = 15-29 mL/min)
Stage 5
: end stage CKD (GFR < 15 mL/min)
serum creatinine
Treatments
control blood pressure
treat hypertension
meet blood glucose goal if already have diabetes
follow-up routine lab work
medicinal prescriptions
Kidney transplant if CKD gets to worse stage
healthy weight - physical activity
stop smoking
healthy ways to cope with stress/depression
start dialysis
peritoneal dialysis
hemodialysis
get connect with a dietitian to maintain kidney health and prevent worsening stages
Risk Factors
Diabetes
too much glucose damages kidney filters
High Blood Pressure
can be a cause or a result of CKD
Heart Disease
increases chances for stroke or heart attack
increases chances of getting CKD if heart disease last for a long period of time
Family history of kidney failure
Getting older
higher chances for change in kidney function causes acute kidney injury
Genetic disorder PKD
Lupus Nephritis
Alport syndrome
Anti-GBM (Goodpasture's) disease
lead poisining
Gout
Metabolic acidosis
hyperphosphatemia
Hyperkalemia
Systemic hypertension
Anemia