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Chronic kidney disease (CKD) - Coggle Diagram
Chronic kidney disease (CKD)
Definition
Progressive deterioration of renal function and presence of kidney damage - albuminuria and proteinuria
abnormality of kidney function for >3 months, GFR <60 - 2 occasions over period of 90 days
Causes
Hypertension
cause lumen to narrow - reducing blood supply to glomerulus
ischaemic injury to glomerulus
activation of immune cells to glomerulus - production of extracellular matrix
glomerulus sclerosis - reducing GFR and therefore blood filtration
Diabetes
excess glucose stick to proteins in efferent arterioles
causing arteriole becoming stiff and narrow
less blood able to leave efferent arteriole; increasing pressure at afferent arteriole
no pressure gradient - reduced GFR
Diagnosis
Signs and symptoms
Signs: HTN, fluid overload, malar flush
Symptoms: nausea, anorexia, vomiting, lethargy, frothy urine
Investigations
urine dipstick: proteinuria, haematuria
urine albumin: creatine ratio
U&Es: identify electrolyte balance
FBC
Investigate underlying cause
Management
Treat underlying cause to prevent further renal dysfunction
Lifestyle management: smoking and alcohol cessation, regular exercise, low salt diet
avoid nephrotoxic medication: NSAIDs/ antibiotics/ contrast dye
Blood pressure control: ACEi or ARB
deal with other conditions caused by CKD like anaemia; iron replacement
Renal replacement therapy
given to patient who are end stage (CKD 5)
RRT can include dialysis - filtration of blood via artificial semi permeable membrane using a dialysis machine
lots of different options for dialysis: like home dialysis, necessary to preserve renal function
Complications
anaemia
gout (increased urea)
metabolic acidosis
fluid overload
hyperkalaemia