Sandeep Vetteth
GFR 90 ml/min/1.73
m2
Stage 2
GFR 60-89
Stage 3
Moderate GFR
GFR 30-59
Stage 4
Severe GFR
GFR 15-29
Stage 5
Kidney failure
In
di
an
n
A
m
er
A
sia
ac
k
Bl
hi
te
Other
Interstit N
Cystic KD
GN
BP
Diabetes
A
ll
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
They
of GFR
of GFR
Mellitus
Hypertension
Cardiovascular Disease
Obesity
Metabolic Syndrome
Age and Race
Acute Kidney Injury
Malignancy
Family
history of CKD
Kidney Stones
Infections like Hep C
and HIV
Autoimmune diseases
Nephrotoxics like
NSAIDS
CKD - Causes
Diabetic
Non
Diabetic
Glomerular
Nephritic:
CKD - Causes
CKD - Manifestations
CKD - Management
CKD - Management
Diagnostic
CKD - Evaluation
CKD - Evaluation
Serum
electrolytes
Urine spot protein analysis (24 hour no longer
recommended).
ANA, C3, C4
SPEP, UPEP
Kidney Ultrasound
Urine sediment analysis
Biopsy
Evidence of glomerular disease without diabetes
Sudden onset of nephrotic syndrome or glomerular
hematuria
CKD - Management
Diagnostic
CKD - Hypertension
Anti-Hypertensive
Agents
CKD - Dyslipidemia
Dyslipidemia
CKD - Management
Diagnostic
CKD - Anemia
Decreased
quality of
life with anemia.
Diagnosis of exclusion.
Mostly apparent in the
stage 4 and 5 of CKD.
Due to decrease in
EPO production in the
kidney.
CKD - Anemia
Erythropoietin
CKD - Management
Diagnostic
CKD - Hyperphosphatemia
Control
of Hyperphosphatemia
CKD - Management
Diagnostic
CKD - Nephrotoxics
Avoidance
of Dehydration/Nephrotoxic Agents
CKD - Management
Diagnostic
Dosing of Drugs
Dose
CKD - Management
Diagnostic
CKD - RRT
Preparation
CKD - RRT
Indications
Indications
(Absolute):
(Relative):
CKD - RRT
Transplantation:
Preemptive transplant
carries both patient and
graft survival
advantage.
Graft survival better
with living donor
kidneys.
Immunosuppresion is
almost always a must.
CKD - RRT
Transplantation:
(recent or metastatic)
Current infection
Severe extra renal disease
Active use of illicit drugs
CKD - Summary
In
Chlorthalidone
Losartan
Metoprolol
Minoxidil
Amlodipine