Chronic Kidney Disease (CKD)
Chronic Kidney Disease (CKD) is gradual, irreversible decline in kidney function, characterised by a decreased GFR (< 60) or markers of kidney damage (albuminuria, electrolyte abnormalities, structural or histological renal abnormalities) present for 3 + months.
Causes
Diabetes
Hypertension
Chronic glomerulonephritis
Polycystic kidney disease
Renal artery stenosis
Amyloidosis, myeloma
Staging
Stage 1 - eGFR is > 90 with demonstrable kidney damage
Stage 2 - eGFR is 60-89 with demonstrable kidney damage
Stage 3 - eGFR is 30-60 - CKD diagnosis is made from here
Stage 4 - eGFR is 15-30
Stage 5 - eGFR is < 15 - End-stage renal failure
Complications
Cardiovascular disease (CVD)
HTN
Anaemia (low EPO)
Electrolyte imbalance (metabolic acidosis, hyperkalaemia)
Renal bone disease
Peripheral/pulmonary oedema
Peripheral neuropathy
N.B. CVD is the most common cause of death in those with CKD.
Management
Control DM
Control HTN - ACEi 1st line
Iron supplementation and EPO for anaemia
Salt restriction and diuretics for oedema
Vit D for renal bone disease
Sodium Bicarbonate for metabolic acidosis

