(Peri-Op & Anaesthesia) (GP)

Overview

• Abnormality of kidney structure or function (GFR <60 mL/minute/1.73 m²) that is present for ≥3 months
• Risk Factors → diabetes, hypertension, obesity, advanced age, substance use, AKI, black or hispanic ethnicity
• Aetiology → diabetic nephropathy (38%), hypertensive nephropathy (26%), glomerulonephritis (16%), polycstic kidney disease (most common genetic cause, autosomal dominant, screen relatives with abdominal ultrasound)
• Functions of Kidney

Making Diagnosis

Clinical Features:

Mainly manifestations of Uraemia and Hyperphosphataemia (lack of excretion of toxic substances) or Anaemia (lack of EPO produced by kidney)

• Often Asymptomatic → may be finding of routine blood test or urine test
• Fatigue
• Oedema (Peripheral/Pulmonary) → due to Na/H20 retention
• Nausea
• Pruritus → due to uraemia
• Hypertension
• Symptoms of Hypocalcaemia (due to 1-alpha-hydroxylase deficiency) → tetany, muscle twitching, paraesthesia, arrhythmias