Chronic Kidney Disease (CKD)

 

u Kidney damage or GFR <60ml/min/1.73m² for 3mo or longer.

o   Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies.

·        Caused by either primary renal disease or secondary to a systemic disease

·        Risk factors for secondary causes include: DM, family history of CKD, Chronic use of NSAIDS, obesity and smoking

·        Screening is recommended for people with DM, Hypertension, family history of CKD using U/A, serum creatinine, etc

 

u AKI vs CKD - Features that support CKD include

·        Band keratopathy

·        Chronic anemia that is otherwise unexplained

·        Sustained increase in serum creatinine

·        Kidneys measuring <10cm in length on renal ultrasonography

·        Radiologic evidence of subperiosteal erosions consistent with advanced renal osteodystrophy

u Epidemiology

·        Growing public health problem worldwide

·        Significant racial and ethnic differences particularly at advanced ages. Africans and Hispanics have higher prevalence than whites

u Diagnosis

·        By GFR – MDRD, Cockroft-Gault formula

·        Cockroft-Gault formula

o       C_cr = (140-age) x body wt in Kg/(72xS_cr)

o       Multiply by 0.85 for females

u Management

·        Treat/Manage/control comorbidities – DM, Htn, Smoking, Obesity

·        Renal Replacement therapy – Dialysis

·        Renal transplant

 

u Complications

·        Electrolyte imbalances

·        Volume overload

·        Anemia

·        Encephalopathy

·        CVS those caused by AKI

·        Renal osteodystrophy