革山院 Chronic Kidney Diseases (CKD Minmin zhang Division of Nephrology ashan Hospital, Fudan Univeristy
Chronic Kidney Diseases (CKD) Minmin Zhang Division of Nephrology Huashan Hospital, Fudan Univeristy
革山院 Contents Definition, stage, epidemiology of CKD Causes and pathophysiology of CKD Clinical and laboratory manifestations of CKD Treatment of cKd
Contents • Definition, stage, epidemiology of CKD • Causes and pathophysiology of CKD • Clinical and laboratory manifestations of CKD • Treatment of CKD
革山院 Chronic Kidney Diseases(CKD) Definition (NKF-K/) CKD presence of kidney damage gFR 3 months ≥>3 months Loss of kidney function Kidney damage
Chronic Kidney Diseases (CKD) ---Definition (NKF-K/DOQI) •GFR <60 mL/min •with or without kidney damage • ≥3 months CKD •presence of kidney damage •pathologic abnormalities •markers of kidney damage • imaging tests •≥3 months Loss of kidney function Kidney damage
革山院 ) Defining“ Kidney Damage” a Pathologic abnormalities By Radiology (Us, CT, Mr, etc)e.g Multiple cysts consistent with PKd 上 xtensive scarring Small kidneys REMEMBER: Renal masses or complex cysts that are not simple should be referred to a UROLOGIST!! By Histology--ie, renal biopsy
Defining ―Kidney Damage‖ Pathologic Abnormalities By Radiology (US, CT, MR, etc)--e.g. Multiple cysts consistent with PKD Extensive scarring Small kidneys REMEMBER: Renal masses or complex cysts that are not simple should be referred to a UROLOGIST!! By Histology--ie, renal biopsy
革山院 ) Defining“ Kidney Damage” Markers of Kidney Damage Proteinuria Microalbuminuria Hematuria(especially when seen with proteinuria) Isolated hematuria has a long differential: infection stone malignancy, etc Casts(especially with cellular elements
Defining ―Kidney Damage‖ Markers of Kidney Damage Proteinuria Microalbuminuria Hematuria (especially when seen with proteinuria) Isolated hematuria has a long differential: infection, stone, malignancy, etc. Casts (especially with cellular elements)
革山院 Definition Chronic kidney disease( CKD) Chronic renal failure (CrF) End stage renal diseases (ESrD) Uremia
Definition • Chronic kidney disease (CKD) • Chronic renal failure (CRF) • End stage renal diseases (ESRD) • Uremia
革山院 Definition Chronic kidney disease(CKd) A spectrum of different pathophysiologic processes associated with abnormal kidney function and a progressive decline in GFR A spectrum of clinical problems beginning with abnormalities detectable only by laboratory testing to a late stage, labeled uremia
Definition • Chronic kidney disease (CKD) – A spectrum of different pathophysiologic processes associated with abnormal kidney function and a progressive decline in GFR – A spectrum of clinical problems beginning with abnormalities detectable only by laboratory testing to a late stage, labeled uremia
革山院 Definition Chronic renal failure(Crf) a pathophysiologic process with multiple causes that lasts >3 months and results in progressive, irreversible attrition of the number and function of nephrons Typically corresponds to CKd stages 3-5 Frequently leads to end-stage renal disease (ESrD)
Definition • Chronic renal failure (CRF) – A pathophysiologic process with multiple causes that lasts > 3 months and results in progressive, irreversible attrition of the number and function of nephrons – Typically corresponds to CKD stages 3–5 – Frequently leads to end-stage renal disease (ESRD)
革山院 Definition End stage renal diseases ( esrd) Clinical state in which irreversible loss of endogenous renal function has occurred Patients are permanently dependent on renal replacement therapy to avoid life-threatening uremia CKD Stage 5 Uremia a clinical syndrome reflecting dysfunction of all organ systems due to untreated or undertreated acute or chronic renal failure
Definition • End stage renal diseases (ESRD) – Clinical state in which irreversible loss of endogenous renal function has occurred – Patients are permanently dependent on renal replacement therapy to avoid life-threatening uremia. – CKD Stage 5 • Uremia – A clinical syndrome reflecting dysfunction of all organ systems due to untreated or undertreated acute or chronic renal failure
Stage and prevalence of cKd GFR Prevalence Stage Description (m/min/1.73 N m (1000s) Kidney Damage 1 with normal or个 ≥90 5,9003.3 GFR Kidney damage 60-89 5,30030 234 with mild↓GFR Moderate√GFR 30-59 7.6004.3 Severe」GFR 15-29 4000.2 Kidney Failure <15 or Dialysis 3000.1
Stage and Prevalence of CKD Stage Description GFR (ml/min/1.73 m2 ) Prevalence N (1000s) % 1 Kidney Damage with Normal or GFR 90 5,900 3.3 2 Kidney Damage with Mild GFR 60-89 5,300 3.0 3 Moderate GFR 30-59 7,600 4.3 4 Severe GFR 15-29 400 0.2 5 Kidney Failure < 15 or Dialysis 300 0.1