Chronic renal failur1 - CKD Diagnosis There are a number of...

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Chronic renal failure Causes Some of the more common causes in CRF include: o Hypertension and Diabetes mellitus o Glomerulonephritis, renovascular disease, pyelonephritis, benign prostatic hyperplasis, stones, polycystic disease o Rarely – amyloidosis, SLE, gout, myeloma, renal tumour Nephrotoxic drugs - Need to reduce dose according to dose adjustment factor (DAF) for a particular drug e.g. Aminoglycosides (Gentamicin), Lithium, Cephalosporins, Digoxin, Tetracyclines, Ethambutol. Epidemiology In Canada 1.9 to 2.3 million people have chronic kidney disease. In the US, the Centers for Disease Control and Prevention found that CKD affected an estimated 16.8% of adults aged 20 years and older, during 1999 to 2004. UK estimates suggest that 8.8% of the population of Great Britain and Northern Ireland have symptomatic
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Unformatted text preview: CKD. Diagnosis There are a number of tests which can be performed to confirm the diagnosis of CRF: o Bloods – Hb, U&E, glucose, calcium/phosphate (raised/lowered), raised ALP, raised PTH o Urine – MC&S, dipstick, 24hr urinary protein o eGFR o Imaging – Renal US – usually renal size is small (<9cm) by may be normal or enlarged in DM, polycystic kidney, amyloidosis, myeloma), CXR, Bone XR (renal osteodystrophy) o Renal biopsy – if cause unclear and normal sized kidneys. Classifications (Stages of GFR decline): o 1 = >90 o 2 = 60-89 o 3a = 45-59 o 3b = 30-44 o 4 = 15-29 o 5 = <15 Patients are usually only symptomatic at stage 4 (GFR <30)! / Urea >40mmol/L...
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