Chronic Kidney Disease (CKD) (Study Outline) 1. Background…
Chronic Kidney Disease (CKD) (Study Outline) 1. Background Definition: Persistent kidney dysfunction ≥3 months with structural or functional abnormalities, often with decreased GFR. Epidemiology: Common in diabetes and hypertension; major contributor to cardiovascular morbidity. Pathophysiology: Nephron loss → compensatory hyperfiltration → progressive sclerosis. Declining GFR → impaired fluid, electrolyte, acid-base, endocrine functions. Common causes (high-yield): Diabetes mellitus (#1) Hypertension (#2) Glomerulonephritis, polycystic kidney disease, chronic obstruction, recurrent pyelonephritis. Staging: Based on GFR and albuminuria categories. 2. History Often asymptomatic in early stages. General symptoms: fatigue, weakness, anorexia, pruritus. Fluid/electrolyte symptoms: edema, dyspnea, nocturia. Uremic findings (late): nausea, metallic taste, cognitive changes. Comorbid condition clues: longstanding diabetes, poorly controlled hypertension. Medication history relevant for nephrotoxins. 3. Exam Findings Vital signs: hypertension common. Volume status: peripheral edema, pulmonary crackles (volume overload). Skin: uremic frost (late, rare), hyperpigmentation. Neuro: asterixis in advanced uremia. Cardiac: pericardial rub (uremic pericarditis). Findings of underlying disease: e.g., diabetic neuropathy, retinopathy. 4. Making the Diagnosis Key labs: Persistent ↓ GFR (