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    CKD - Esrf

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    Ee Chen Heng

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    CKD - Esrf

    Uploaded by

    Ee Chen Heng
    5 views10 pages

    Original Title

    CKD _ ESRF

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    Download as pptx, pdf, or txt
    5 views10 pages

    CKD - Esrf

    Uploaded by

    Ee Chen Heng

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 10

    CHRONIC KIDNEY DISEASE

    • CKD refer to an irreversible deterioration in renal function


    • Usually develops over period if years
    Stages of chronic kidney disease
    Causes
    Physical signs in advanced CKD
    INVESTIGATIONS
    Proteinuria
    • Albumin-to-creatinine ratio(ACR) - >3.0 mg/mmol is diagnostic for
    chronic kidney disease, urine testing should be repeated in another 3
    months
    Creatine clearance/eGFR
    • E.g : 56 yo male, 70 kg, serum creatinine- 150

    (140-56x70/150) x 1.23 = 48.2


    P.S: google gfr calculator
    Ultrasound
    General indications for renal ultrasound
    • rapid deterioration of renal function (loss of eGFR >5 ml/min/1.73 m2
    • within one year or 10 ml/min/1.73 m2 within five years)
    • haematuria
    • symptoms or history of urinary tract obstruction
    • family history of polycystic kidney disease and age over 20 years
    • when a renal biopsy is indicated
    Treatment
    • Blood pressure control: ACEi/ARB should be used as first-line agent in
    • Diabetic kidney disease (DKD) with albuminuria
    • Non-DKD when urinary protein excretion ≥1.0 g/day
    • Non-DKD with hypertension when urinary protein excretion ≥0.5 g/ day
    • Glycaemic Control:
    • The target HbA1c should be ≤7% in diabetic kidney disease but this should be
    individualized according to co-morbidities and age
    • Protein Restriction:
    • Low protein diet (0.6 - 0.8 g/kg/day) with adequate energy intake (30 - 35
    kcal/kg/day) may be given in chronic kidney disease stage 3 – 5
    • Dietary protein restriction should be supervised by a dietitian.
    End Stage Renal Failure
    • Irreversible kidney dysfunction
    with eGFR < 15 mL/min/1.73
    m2 with manifestation of
    uremia requiring chronic renal
    replacement therapy with
    either dialysis or renal
    transplantation

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