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CHRONIC KIDNEY DISEASE - Coggle Diagram
CHRONIC KIDNEY DISEASE
Definition
long-term condition in which the kidneys gradually lose their function over time. Characterized by a persistent decline in kidney function: decreased GFR and/or presence of kidney damage (proteinuria, structural abnormalities) for > three months.
Pathogenesis
Nephron loss triggers hyperfiltration and glomerular hypertension, leading to further damage.
Proteinuria induces inflammation and tubulointerstitial fibrosis, while oxidative stress and cytokines (e.g., TGF-β, TNF-α) accelerate scarring.
CKD begins with kidney injury due to diabetes, hypertension, glomerulonephritis, or genetic disorders.
Progressive fibrosis causes nephron dropout, declining GFR, and eventually ESRD, requiring dialysis or transplantation.
Clinical features
polyuria, nocturia, oliguria
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peripheral neuropathy (tingling, numbness)
Investigations
Electrolytes → Check for hyperkalemia, metabolic acidosis
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Treatment
Slow progression → ACEi/ARBs, low-sodium/protein diet, avoid nephrotoxins
Manage complications → EPO for anemia, correct electrolytes
Control cause → Diabetes (HbA1c <7%), Hypertension (BP <130/80, ACEi/ARBs)
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Examination findings
cvs: raised JVP, pericardial friction rub
resp: kaussmal breathing, basal crepitations
general: pallor, edema, hypertension, cachexia
neuro: asterixis, peripheral neuropathy (decreased sensation, absent reflexes)
abdominal: ballotable kidneys, ascites
derma: pruritus, xerosis, uremic frost
Prevention
Healthy lifestyle → Low-salt/protein diet, exercise, no smoking
Avoid nephrotoxins → NSAIDs, contrast agents
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Risk Factors
Obesity, smoking, aging (>60 years)
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