Chronic kidney disease (CKD)

Chronic kidney disease (CKD)

Pathology:                Progressive, irreversible renal disease with abnormal eGFR for >3 months


Aetiology:                 Diabetes mellitus, hypertension, HIV, myeloma, Autosomal dominant polycystic kidney disease and IgA nephropathy.

Symptoms:               Oliguria, Malaise, lethargy, confusion, nausea, seizure, pruritus, purpura, breathlessness, pericarditis, bleeding

Signs:                          Reduced urine output, rash, peripheral oedema, arrhythmias, signs of heart failure, pallor, bruising and skin pigmentation

Investigations:      Bloods: FBC (normocytic anaemia), U&E (hyperkalaemia, raised urea and                                                 creatinine, hypocalcaemia, hyperphosphataemia)

                                        Imaging: Chest x-ray to rule out fluid overload and bone scans

Treatment:              Medical: Calcium and Vitamin D supplementation, Dietary restriction of

                                                       phosphate, Dialysis for severe symptoms

                                        Surgical: Kidney Transplant


Complications:      Hyperkalaemia, fluid overload, uraemia, renal osteodystrophy, hypertension

Prognosis:               50% of patients with chronic renal failure will require dialysis

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