Notes on Chronic Kidney Disease (CKD) Lecture by Dr. Nitesh Raj

Introduction to CKD

CKD: Chronic Kidney Disease, also known as Chronic Renal Failure.
Definition: A disease with gradual damage to the kidneys lasting more than 3 months.
Difference from Acute Kidney Injury (AKI):
- AKI occurs suddenly and can be reversible if treated.
- CKD is progressive and irreversible.

Common Causes:
- Diabetes
- Hypertension
- Polycystic Kidney Disease
- Glomerular Nephritis
- Drug-induced, especially painkillers.
Pathophysiology:
- Slow, continuous damage to kidneys causing loss of filtration ability.

Symptoms:
- Volume overload: Puffy eyes, pulmonary edema.
- Electrolyte imbalances: Sodium and potassium issues.
- Acidosis: Increased H+ levels; leads to metabolic acidosis.
Testing:
- Estimated Glomerular Filtration Rate (eGFR)
- Albumin-creatinine ratio for staging the disease.

Electrolyte Imbalance:
- Hyperkalemia: High potassium levels; can lead to cardiac arrest.
- Acidosis: Increased H+ levels; decreased bicarbonate.
Bone Health:
- Calcification: High phosphate levels lead to low calcium; risk of renal osteodystrophy.
Anemia: Low erythropoietin production leads to reduced RBC formation.
Cardiovascular Risk: Increased risk due to elevated cholesterol and phosphates.

Lifestyle Changes:
- Control blood pressure and blood sugar.
- Dietary restrictions: Low protein, low potassium, low phosphate.
Medications:
- Acidosis Management: Sodium bicarbonate.
- Phosphate Control: Phosphate binders and dietary modifications.
- Calcium Deficiency: Supplementation with active Vitamin D.
- Anemia Management: Erythropoietin injections and iron supplements.
Hyperkalemia Treatment:
- Calcium gluconate for cardiac stabilization.
- Insulin and dextrose to shift potassium into cells.
- Dietary potassium restriction.

Monitoring: Regular checks on potassium and creatinine levels when on ACE inhibitors or ARBs.
Emerging Treatments:
- N-Acetyl Cysteine (NAC): Antioxidant properties; may help in slowing down CKD progression.
- Alpha-ketoanalogues: Amino acids without nitrogen, reducing nitrogenous waste.
Consultation: Regular follow-ups with nephrologists for tailored treatment plans.

CKD is a progressive disease requiring careful management but can be slowed down with appropriate interventions and lifestyle changes.
Important to spread awareness and control contributing factors such as diabetes and hypertension.

Note: This summary aims to capture the essential points discussed in the lecture for better understanding of Chronic Kidney Disease.