Chronic Kidney Disease (CKD) for PLAB 1
Chronic Kidney Disease (CKD) is a progressive loss of kidney function over months or years. Understanding its causes, symptoms, diagnosis, and management is crucial for PLAB 1 preparation, as it's a common condition encountered in clinical practice.
Definition and Stages of CKD
CKD is defined by abnormalities of kidney structure or function, present for more than three months, with implications for health. The severity is staged based on the estimated Glomerular Filtration Rate (eGFR), a measure of how well your kidneys are filtering waste.
| Stage | eGFR (mL/min/1.73m²) | Description |
|---|---|---|
| 1 | ≥ 90 (with kidney damage) | Kidney damage with normal or increased GFR |
| 2 | 60-89 (with kidney damage) | Kidney damage with mildly decreased GFR |
| 3a | 45-59 | Moderately decreased GFR |
| 3b | 30-44 | Moderately to severely decreased GFR |
| 4 | 15-29 | Severely decreased GFR |
| 5 | < 15 or dialysis | Kidney failure |
Common Causes of CKD
The most prevalent causes of CKD are diabetes mellitus and hypertension. Other significant contributors include glomerulonephritis, polycystic kidney disease, and recurrent urinary tract infections or obstructions.
Diabetes Mellitus and Hypertension.
Clinical Manifestations of CKD
CKD often progresses silently in its early stages. As it advances, symptoms can include fatigue, swelling (edema), changes in urination (frequency, volume, foamy urine), nausea, loss of appetite, muscle cramps, and shortness of breath. Complications can affect multiple organ systems.
Diagnosis and Monitoring
Diagnosis relies on blood tests (serum creatinine to estimate eGFR, electrolytes, complete blood count) and urine tests (proteinuria, hematuria). Imaging studies like ultrasound can assess kidney size and structure. Regular monitoring of eGFR, blood pressure, and urine protein is essential.
The kidney's role in filtering blood and producing urine is central to understanding CKD. The nephron, the functional unit of the kidney, comprises a glomerulus for filtration and a tubule for reabsorption and secretion. In CKD, the damage to these structures impairs their ability to perform these vital functions, leading to waste product accumulation and fluid imbalance.
Text-based content
Library pages focus on text content
Management of CKD
Management focuses on slowing disease progression, managing complications, and treating underlying causes. This includes strict blood pressure control (often with ACE inhibitors or ARBs), glycemic control in diabetics, dietary modifications (low sodium, potassium, and protein as advised), and management of anemia, bone disease, and cardiovascular risk factors.
For PLAB 1, remember that ACE inhibitors and ARBs are often first-line agents for blood pressure control in CKD, especially in patients with proteinuria, as they offer renal protective benefits.
Renal Replacement Therapy
For patients with end-stage renal disease (Stage 5 CKD), renal replacement therapy is necessary. This includes dialysis (hemodialysis or peritoneal dialysis) or kidney transplantation. The choice depends on individual patient factors and preferences.
Hemodialysis and Peritoneal Dialysis.
Learning Resources
Provides a comprehensive overview of CKD, including causes, symptoms, diagnosis, and treatment options from a UK perspective.
A detailed explanation of CKD, its stages, common causes, and management strategies, suitable for understanding the broader clinical picture.
Official UK guidelines from NICE on the early identification and management of CKD, essential for understanding current clinical practice standards.
A clear and concise video explaining the pathophysiology, clinical presentation, and management of CKD, ideal for visual learners.
Offers patient-friendly information on CKD, including its impact on the body and how it is managed.
A blog post specifically tailored for PLAB 1 preparation, focusing on the renal system and common topics like CKD.
A comprehensive medical overview of CKD, including detailed pathophysiology, diagnosis, and treatment, suitable for in-depth study.
Explains the different stages of CKD in an accessible manner, helping to understand the progression and implications of each stage.
Provides information on common laboratory tests used to assess kidney function, crucial for understanding CKD diagnosis and monitoring.
Offers global statistics and a concise overview of CKD as a public health issue, providing context for its importance.