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Chronic Kidney Disease Presentation

Physiology 1011
by

Dimuthu Wickramasinghe

on 28 March 2012

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Transcript of Chronic Kidney Disease Presentation

Chronic Kidney Disease
(CKD)

By Dimuthu Wickramasinghe
Kidney Function
The Disease
Treatment & Precautions
Bibliography
Enlarged Kidney
Location of Kidney
Nephron
Glomerulus/Bowman's Capsule
Causes
Stages of CKD
Stage 1: Kidney damage (GFR at least 90 mL/min/1.73 m2)
Evidence of kidney damage but without decreased GFR. Usually no
symptoms.
Stage 2: Kidney damage (GFR 60 to 89 mL/min/1.73 m2)
Evidence of kidney damage with some reduction in GFR. Most patients
have no symptoms.
Stage 3: GFR 30 to 59 mL/min/1.73 m2
GFR significantly reduced. May show signs of kidney damage and often
indications of dysfunction in other organs. Often asymptomatic despite a
reduction in kidney function of up to 70%.
Stage 4: GFR 15 to 29 mL/min/1.73 m2
Kidney function significantly reduced. Blood levels of urea and creatinine
increase, and greater evidence of dysfunction in other organs. Usually
only mild symptoms.
Stage 5: End Stage Kidney Disease (ESKD) GFR less than 15 mL/min/1.73 m2
Range of symptoms and laboratory abnormalities in several organ
systems, collectively referred to as uraemia.
* Cited from: Green F & Ryan C 2009. An overview of chronic kidney disease in Australia, 2009. Cat. no. PHE 111. Canberra: AIHW
GFR
http://www.youtube.com/watch?v=lH9IXpp5zTU.
Diabetic Nephropathy
Diabetes causes lack of insulin, a hormone that controls the amount of sugar in the blood
High Blood sugar levels cause Nephrons to thicken and allow more Protein than necessary to filter out into the Bowman's Capsule
This decreases GFR and may lead to Stage 5 CKD and ESRD, which ultimately ends in Death
Glomerulonephritis
Gazi Salahuddin Siddiquee, Lecturer, Agrani School and College, Azimpur, Dhaka-1205, Bangladesh
Renal Resource Centre, 2010
Hypertension
Screen Dumps from:
http://www.youtube.com/watch?v=ikGl7DPXUK0.
Hypertension is the increase of blood pressure
Outer wall becomes thicker
Diameter of interior becomes smaller
Reduced blood flow, lower GFR
ESRD
Treatment
Precautions
High Blood Pressure
Kidney Transplant
Angeotensin II constricts blood vessels
Decreases Blood flow
Subsequently decreases GFR
ACE, allows the conversion of Angeotensin to Angeotensin II
ACE Inhibitors stop the function of the ACE peptide
This effectively dilates the once constricted vessels
Donors are placed under anaesthetic, and the removal of the kidney is pain-free
Recepients receive the donor kidney much the same way as it is removed, except arteries are connected rather than severed
Both Donor and Recipient will lead normal lives despite having only 1 functioning kidney
http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/10247.jpg,
Visit the General Practitionar on a yearly basis for a full checkup. Or if any of these symptoms persist
Apetite Loss
Fatigue
Nausea
Unexpected Weight Loss
Headaches
Lower Back Pain
& Symptoms
Thank
You
Rao, Madhav V. ; Qiu, Yang ; Wang, Changchun ; Bakris, George
American Journal of Kidney Diseases, 2008, Vol.51(4), pp.S30-S37 [Peer Reviewed Journal]
Green F & Ryan C 2009. An overview of chronic kidney disease in Australia, 2009. Cat. no. PHE 111. Canberra: AIHW
"Diabetic Nephropathy." Diabetes Care Jan. 2000: S69. Academic OneFile. Web. 27 Mar. 2012.
http://www.youtube.com/watch?v=lH9IXpp5zTU, Gazi Salahuddin Siddiquee, Lecturer, Agrani School and College, Azimpur, Dhaka-1205, Bangladesh
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001524/
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61. [PubMed]

Inzucchi SE, Sherwin RS. Diabetes Mellitus. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 248.

American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care.27(Suppl 1): S79�S83. [PubMed]

Parving H, Mauer M, Ritz E. Diabetic Nephropathy. In: Brenner BM. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 36.

http://www.nlm.nih.gov/medlineplus/ency/article/000484.htm
Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 122.
Nachman PH, Jennette JC, Falk RJ. Primary glomerular disease. In: Brenner BM, ed. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 30.
http://www.nlm.nih.gov/medlineplus/ency/article/003005.htm
Barry JM, Jordan ML, Conlin MJ. Renal transplantation. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 40.
Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9 Suppl 3:S1-155.
ACE (angiotensin converting enzyme) definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms. 2012. ACE (angiotensin converting enzyme) definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms. [ONLINE] Available at: http://www.medterms.com/script/main/art.asp?articlekey=2107 . [Accessed 28 March 2012].

Curtis, H & Barnes, N.S c1989, Biology, Worth Publishers Inc, New York
Similar to Diabetic Nephropathy as Glomerulonephritis causes protein to be excreted
Can be caused by inflammation of capilaries, Some Immune diseases but often the cause is unknown
This decreases GFR and may lead to Stage 5 CKD but symptoms take a long time to appear.
Despite these symptoms, it is difficult to detect CKD without proffessional help.
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