CKD

CKD

1. Clinical Manifestations

   • Urinary System
     • Early Stages
       • Nocturia & Polyuria-Kidneys inability to concentrate urine
     • Late Stages
       • Oliguria, then eventually anuria (40ml/24hr output), possible proteinuria casts, hematuria & pyruia
   • Cardiovascular System
     • Hypertension, Heart Failure, Edema and Coronary Artery Disease
   • Respiratory System
     • Dyspnea- from fluid overload, uremic pneumonitis and pleuritis
   • Gastrointesinal System
     • Nausea, vomiting, poor appetite and GI bleed
   • Hematological System
     • One of the most common- Anemia
     • Infection- increased susceptibility in CKD patients
     • Bleeding tendancies
   • Neurological System
     • Fatigue, Headache, and sleep disturbances

2. Stages

   • Stage 1
     • Early Kidney damage, with early or elevated GFR
       • GFR- ml per min per 1.73m^2
         • GFR greater than 90
           • Action
             • Diagnosis and treatment of co-morbid conditions
   • Stage 2
     • Progressive kidney damage with mildly decreased GFR, (early renal insufficiency)
       • GFR- 60-89
         • Action
           • Estimation with Progression
   • Stage 3
     • Moderate decreased GFR, (moderate kidney failure)
       • GFR- 30-59
         • Action
           • Evaluation and treatment of complications
   • Stage 4
     • Severe decrease GFR- (pre-end stage kidney disease
       • GFR- 15-29
         • Action
           • Begin the preparation for renal replacement therapy
   • Stage 5
     • Kidney failure (end stage kidney disease
       • GFR- 15 or less or dialysis
         • Action
           • The starting process of renal replacement therapy
   • Figure 1

3. Figure 2

4. Treatment and Management

   • Early Stages
     • Anemia Treatment
     • Nutritional Therapy
       • Phosphate balance
       • Protein Restriction
       • Sodium and Fluids Management
     • Hypertension Management
   • Late Stages

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