Outline the stages of CKD, including the distinguishing signs and symptoms
What will be an ideal response?
The general course of progress kidney failure is now divided into five stages.
Stage Description GFR (mL/min/1.73 m2)
-- At increased risk ?60 (with CKD risk factors)
1 Kidney damage with normal or increased GFR ?90
2 Kidney damage with mild decrease in GFR 60-89
3 Moderate decrease in GFR 30-59
4 Severe decrease in GFR 15-29
5 Kidney failure <15 (or dialysis)
• CKD is defined as either kidney damage or GFR <60 mL/min/1.73 m2 for ?3 months.
• Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies.
Signs, symptoms, and laboratory abnormalities distinguish disease pathophysiology.
• Elevated BUN and creatinine
• Nocturia
• Lassitude
• Fatigue
• Decreased mental acuity
• Neuromuscular: coarse muscular twitches, peripheral neuropathies with sensory and motor phenomena, muscle cramps, and convulsions
• Anorexia, nausea, vomiting
• Stomatitis
• Unpleasant taste in mouth
• Malnutrition leading to generalized wasting
• Hypertension
• Cardiomyopathy
• Possibly congestive heart failure or dependent edema (renal retention of Na and water)
• Yellow-brown cast to skin
• Pruritus
• Renal osteodystrophy
• Osteomalacia
• Abnormal lipid metabolism (hypertriglyceridemia)
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