Chronic Kidney Disease

Chronic Kidney Disease

Not that you can possibly care...
GFR (ml/min/1.73 m2) = 186* x
{[Serum creatinine (mmol/l)/88.4] -1.154}
x age (years) -0.203
x 0.742 if female
x 1.21 if African American
(* correction factor depends on creatinine assay)

Stages of Chronic Kidney Disease & GFR (ml/min)

Stage 1
Normal GFR with another abnormality
> 90

Stage 2
Mild reduction in GFR with another abnormality
60-89

Stage 3
Moderate reduction in GFR
30-59

Stage 4
Severe reduction in GFR
15-29

Stage 5
End-stage renal disease
<15 or dialysis

Kidney Damage
•Proteinuria (albuminuria)
•Haematuria (microscopic, macroscopic)
•Abnormalities on imaging studies
•Histological abnormalities on biopsy

Causes of Chronic Kidney Disease
•Diabetes mellitus
•Glomerulonephritis
•Chronic pyelonephritis
•Prostatic hypertrophy
•Renovascular disease

•Multisystem diseases
•Genetic diseases

Management of CKD
Establish a diagnosis
Avoid nephrotoxic drugs
Treat hypertension
Treat complications
Monitor kidney function
Prepare for dialysis and transplantation

The “Uraemic Emergency”
•Pulmonary Oedema
•Peripheral Oedema
•Metabolic acidosis
•Hyperkalaemia
•Uraemic Pericarditis