Presentation on theme: "CKD FOR FINALS Dr H. Elcome, FY1 Dr K. Thompson, FY1."— Presentation transcript:
CKD FOR FINALS Dr H. Elcome, FY1 Dr K. Thompson, FY1
“ Long term disease of the kidneys, causing either albuminuria or reduced function (eGFR) ”
Case Aetiology History and Examination Investigations Management Conservative Medical Surgical Complications Plan
Recognising stigmata of CKD Investigations for CKD Management plan in CKD Pros/cons of RRT Learning objectives
Case A 58 yr old man presents to his GP with a history of feeling generally unwell and lethargic for six months but has not sought medical attention until now. He has reduced exercise tolerance and feels nauseous. What other questions would you like to ask?
Case On further questioning you find he complains of: Puritus resistant to Piriton Generalised aching in his joints and back Increased thirst A yellowing of the skin
Case On Examination: BP 160/95 Jaundice with excoriated skin CV/Resp NAD What tests would you like to order?
Staging StageeGFR 1> 90 260-89 3a 3b 45-59 30-44 415-29 5< 15 or on Renal Replacement Therapy
PCKD COMMON FPE CASE! Usually Autosomal, Dominant (rarer recessive Childhood PCKD) Other organs: Liver Pancreas Heart valves Mitral Regurge. Aneurysms (CoW) SA haemorrhage
History and Examination What are the main functions of the kidney? 1.Excretion Filtration 2.Elimination Via the urine 3.Regulation BP Regulation RAAS Electrolyte balance Vitamin D Calcidiol->Calcitriol Erythropoietin
Anaemia Pallor, SOBOE, Malaise and lethargy Hypertension Signs of fluid overloading Excretion Pruritus, jaundice Electrolyte imbalance Potassium Sodium Headaches, nausea # due to osteomalacia Urinary symptoms Ask about immunosuppressants History and Examination
Don’t forget... In the OSCE, do not forget to look and feel for 1. A/V Fistulae 2. Renal Transplant scar/organ