CKD Renal Impairment

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CKD Renal Impairment by Mind Map: CKD Renal Impairment

1. Drugs

1.1. ACE Inhibitors:

1.1.1. Lisinopril/Ramipril/Captopril

1.2. ARB (angiotensin receptor blockers)

1.2.1. Candesartan/Valsartan

1.3. Antibiotics:

1.3.1. Aminoglycosides

1.3.2. Cephalosporins

1.3.3. Amphotericin B

1.3.4. Bacitracin/Vancomycin

1.4. Chemotherapeutics:

1.4.1. Cisplatin/Carboplatin

1.4.2. Methotrexate.

1.5. Protease Inhibitors Antiviral Drugs (Medicines used to treat HIV)

1.5.1. indinavir (Crixivan)/lopinavir/ritonavir (Kaletra)/nelfinavir (Viracept)/ritonavir (Norvir)

1.6. Illicit Drugs:

1.6.1. Heroin

1.6.2. Methamphetamine

1.7. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):

1.7.1. ibuprofen/naproxen/diclofenac/indomethacin/high-dose aspirin

1.8. Proton Pump Inhibitors (PPIs) & H2 Antagonists

1.8.1. Aciphex, Nexium, Prilosec, Prevacid

1.8.2. Pepcid, Tagamet, Zantac

1.9. Supplements

1.9.1. Wormwood oil

1.10. Laxatives

1.10.1. Compounds containing oral sodium phosphate

1.11. Contrast Dyes

1.11.1. Iodinated compounds (CT contrast): Lipiodol/Utlravist

1.11.2. Gadolinium contrast media (sometimes called a MRI contrast media, agents or ‘dyes’)

2. Diagnostic Workup

2.1. Biochemistry

2.1.1. Urinalysis

2.1.1.1. Albumin/Creatinine Ratio (ACR)

2.1.1.2. Heamaturia

2.1.1.3. albuminuria

2.1.1.4. Glycosuria

2.1.2. GFR/eGFR

2.1.3. K+

2.1.4. Na+

2.1.5. Acidosis

2.1.6. hypoalbuminaemia

2.2. Haematology

2.2.1. anaemia

2.2.1.1. hypochromic-normochromic

2.2.1.2. microcytic-normocytic anaemia

2.3. Immunology

2.3.1. Antiglomerular Antibodies

2.3.2. autoimmune conditions

2.3.2.1. Systemic Lupus Erythematosus (SLE)

2.3.2.2. Goodpasture Syndrome

2.3.2.3. Granulomatosis with Polyangiitis

2.3.2.4. Microscopic Polyangiitis

2.3.2.5. IgA Nephropathy (Berger's Disease)

2.3.2.6. Henoch-Schönlein Purpura

2.3.2.7. Anti-GBM Disease

2.3.2.8. Polyarteritis Nodosa

2.4. Anatomical Pathology

2.4.1. Biopsy

2.5. Diagnostic Imaging

2.5.1. Ultrasound

2.5.2. CT/MRI

2.5.3. Angiography

3. Management

3.1. Dialysis

3.2. Non-Dialysis

4. Renal Function Overview

4.1. Blood pressure regulation

4.1.1. Renin-Angiotensin system

4.1.1.1. RAS

4.1.2. Aldosterone

4.1.2.1. Aldo

4.1.3. Anti-diuretic Hormone

4.2. Electrolyte Balance

4.2.1. Na+

4.2.2. K+

4.2.3. H+

4.2.4. HCO3-

4.2.5. OTHER Ca+/Mg+/Zn/Cu

4.3. Fluid Balance

4.3.1. Excess fluid

4.3.2. Urine production

4.3.2.1. Produces approx. 1-2 L per day

4.3.3. Fluid replenishment

4.4. Filtration

4.4.1. ~ 12 times every hour or

4.4.2. ~ 200 litres of blood per day

4.4.3. Waste and metabolic byproducts

4.4.4. Drug elimination

4.4.5. toxins.

4.5. Protein retention

4.5.1. Albumin

4.5.2. Globulins

4.5.3. OTHER

4.6. Production of Vitamin D

4.7. Production of Erythropoietin

5. Demographics

5.1. Incidence/Age/Sex

5.1.1. Estimated 1 in 10 people (1.7 million Australians) aged >18

5.1.2. Increases rapidly with age, affecting around 4 in 10 (42%) people aged 75 and over.

5.2. Predisposing Factors

5.2.1. CCF CVA

5.2.2. Family history of CKD

5.2.3. Obesity

5.2.4. Smoking or having ever smoked

5.2.5. Age > 60 years

5.2.6. Being of Aboriginal or Torres Strait Islander origin

5.2.7. ARF, kidney injury, infection or cyst in the past

5.2.8. The kidneys can also be damaged by misuse of some painkillers, prescription medicines and illegal drugs.

5.3. Associated Conditions

5.3.1. Diabetes

5.3.2. Hypertension

5.3.3. Anaemia

5.3.4. Ca Metabolism

6. Presentations

6.1. Non Specific

6.1.1. TirednessTirednessTirednessTirednessTiredness

6.1.2. Pruritis

6.1.3. Lethargy/Fatigue

6.1.4. Weight ImbalanceImbalance

6.2. Specific

6.2.1. Filtration Defect

6.2.1.1. Polyuria

6.2.1.2. Hematuria

6.2.1.3. Oedema

6.2.1.4. oliguria

6.2.2. Protein Imbalance

6.2.2.1. proteinuria

6.2.2.2. albuminuria

6.2.2.3. hypo-albumaemia

6.2.2.4. hypo-proteinaemia

6.2.3. Ca Metabolism

6.2.3.1. hyperparathyroidism

6.2.3.2. osteoporosis

6.2.3.3. chondromalacia

6.2.4. Toxic Metabolites/Drug Interactions

6.2.5. Uraemia

6.2.5.1. Azotaemia