Chronic Kidney Disease Flashcards Preview

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Flashcards in Chronic Kidney Disease Deck (12)
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What is a chronic kidney disease?

An umbrella term describing a large spectrum of diseases

Abnormalities/ damage to the kidney structure present for more than 3 months


What are the ways to diagnose CKD?

Kidney structure - kidney biopsy

Kidney function - GFR < 60 ml/min/1.73m2

Damage biomarkers


What are the causes of CKD?

Idiopathic - unknown


Diabetic nephropathy

IgA nephropathy


What is a common feature of CKD following treatment of the underlying cause?

Even after a cause of CKD has been treated - kidney function continues to decline as they scar over time


Pathogenesis of CKD

1. Glomerulus becomes damaged

2. Since the glomerulus supplies the tubules -> nephrons become damaged and ischaemic

3. This triggers inflammation - deposition of collagen

4. Cells around the tubule change phenotype - become more fibrotic = interstitial fibrosis

5. Loss of ischaemic nephron is buffered by the rest of the kidney

6. Blood supply to the healthy nephrons increases

7. Proteins leak from the blood to the tubule = proteinuria

8. Increased P in the glomeruli damages the blood tubules

9. Proteins in tubules change phenotype to inflammatory proteins

10. Infiltration of inflammatory cellls and pro-fibrotic changes in the cells that make up the interstitium = fibrosis

11. Loss of nephrons

12. Cycle of fibrosis and worsening scarring


What is the main feature of chronic kidney failure?

Irreversible depletion of nephrons


How to treat CKD

Treat the underlying disorder

Control blood sugar levels in patients

Immunosuppression in glomerulonephritis


What is a system that is often targeted in the treatment of CKD?

Renin-angiotensin system


What does the renin-angiotensin normally cause?



Which drugs target the renin-angiotensin system?

Renin inhibitor

ACE inhibitor

Angiotensin 2 receptor blocker


Why is the renin-angiotensin system the best system to target in order to reduce renal BP?

Specific to for glomerular pressure

Only affects the kidney


What is essential to control in order to prevent patients from reaching end-stage renal disease?

Blood pressure