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CKD by Mind Map: CKD

1. Causes & Pathophysiology

1.1. Follow Primary Diseases

1.1.1. AKI

1.1.2. Diabetes Mellitus

1.1.2.1. Increase glomerular flow rate --- hyperfiltration --- thickening, sclerosis of glomerular base membrane & glomerulus

1.1.3. Hypertension

1.1.3.1. HBP---- sclerosis & narrowing of renal arterioles ---- reduce blood flow ---- ischemia, glomerular destruction & tubular atrophy

1.1.4. Heart Failure

1.1.5. Autoimmune disorders

1.2. Pre- Kidney

1.2.1. Hypo-volume

1.2.2. Renal artery occlusioin

1.3. Intro-Kidney

1.3.1. Glomerular diseases

1.3.1.1. SLE

1.3.1.1.1. immune complexes form in capillary basement membrane ---- inflammation, sclerosis

1.3.1.2. Medication or drug toxin

1.3.1.3. Chronic glomerulonephritis

1.3.1.3.1. inflammation ---- obstruction & damage to the tubules ---- affecting glomerular filtration & tubular secretion, re-absorption.

1.3.1.4. Polycystic kidney disease

1.3.1.4.1. Multiple bilateral cysts compress renal tissue ---- ischemia, renal vascular remodeling

1.4. Post-Kidney

1.4.1. Chronic urinary obstruction

1.4.2. Recurrent infection

2. Demographics

2.1. Age

2.1.1. >65 yrs :38%

2.1.2. 45-64 yrs: 12%

2.1.3. 18-44 yrs: 6%

2.2. Gender

2.2.1. F (14%) > M (12%)

2.3. Race

2.3.1. non-Hispanic Black (16%) > Hispanic (14%) > non-Hispanic White (13%) = non-Hispanic Asian (13%)

3. Nutrition & Fluid Management

3.1. Low Sodium: < 2g/day

3.2. Stage4&5: Low Potassium < 60-70 mEq/D

3.3. Stage 4&5: Low Phosphrates: strict egg, daily product, meat

3.4. Strict and high quality proteins 0.6g/kg/D; 40g/D

3.5. High Carbohydrate: 35kcal/kg/day

3.6. Water: 1-2L/day

3.7. Monitor weight daily: report weight gain >5lbs /2days (0.5kg/day)

4. Pain Management

4.1. Nonpharmacologic Intervention

4.1.1. Topical thermal therapy

4.1.1.1. Heat

4.1.1.2. Cold

4.1.2. Exercise Programs

4.1.3. TENS

4.2. Pharmacologic Intervention

4.2.1. Mild Pain

4.2.1.1. Nonopioids +/- adjutants

4.2.2. Moderate Pain

4.2.2.1. Nonopioids +/- adjuvants +/- weak opioods

4.2.3. Severe Pain

4.2.3.1. Nonopioids +/- adjuvants +/- moderate to strong opioids

5. Stages & Care Pathyway

5.1. Stage 1

5.1.1. At risk, Normal kidney function GFR >90

5.1.1.1. Primary Care 1:

5.1.1.1.1. Pt info leaflets& advice including lifestyle info; stopping smoking, exercise, weight management

5.1.1.1.2. Treat HPT

5.1.1.1.3. Treat hyperlipidaemia

5.1.1.1.4. Aspirin if indicated

5.1.1.1.5. Review Meds, Avoid NSAIDs

5.1.1.1.6. Influenza/ Pneumococcal vaccine if nephrotic

5.2. Stage 2

5.2.1. Mild, GFR 60-89

5.3. Stage 3

5.3.1. Moderate GFR 30-59

5.3.1.1. CKD

5.3.1.1.1. Primary Care 2

5.4. Stage 4

5.4.1. Severe, GFR 15-29

5.5. Stage 5

5.5.1. End Stage Kidney Disease, GFR <15-30

6. Manufestations

6.1. Urinary Systems

6.1.1. Early: Polyuria, nocturia

6.1.2. Protienuria

6.1.3. Diluted, straw-colored appearance

6.1.4. Hematuria

6.1.5. Later: Oliguria, anuria

6.2. Cardio-Vascular System

6.2.1. Heart Failure

6.2.1.1. Rt-heart-failure

6.2.1.1.1. Peripheral edema

6.2.1.2. Lt-heart-failure

6.2.1.2.1. Pulmonary edema

6.2.1.3. Total-heart-failure

6.2.2. Peripheral edema

6.2.3. Systemic Hypertension

6.2.4. Hypotension, Hypovolium

6.3. Respiratory System

6.3.1. Pumarary Edema

6.3.1.1. SOB

6.3.1.2. Crackles

6.3.1.3. Tachypnea

6.3.2. Uremic pneumonia

6.3.3. Depressed cough reflex

6.4. Integumentary system

6.4.1. Itchy

6.5. GI system

6.5.1. Nausea, vomiting,

6.6. Reproductive system

6.7. Fluid & Electrolyte

6.7.1. Early stage: dehydration

6.7.2. GFR >5ml/min: Hyperkalemia

6.7.3. Hyperphosphatemia & Hypocalcemia

6.7.4. Advancing Stage: Hypermagnesemia

6.7.5. metabolic acidosis

6.8. Neurological System

6.9. Hematological Manifestation

6.9.1. Decline Erythropoietin

6.9.1.1. Anemia

6.9.2. impaired Platelet function

6.9.2.1. Bleeding or bruising

6.10. Musculoskeletal System

6.10.1. Muscle cramping