scarring of glomeruli & loss of nephron mass; glomerular capillary HTN & inflammatory signaling; decreased GFR & increased albuminuria
What is the pathophysiology behind CKD? (3)
inflammatory cells release TGF-B to promote mesangial proliferational; mesangioblasts produce increased ECM which leads to scarring
How does Glomerulosclerosis occur? (2)
interstitial capillaries become permeable causing albumin to leak and trigger inflammatory response/ hypoxia
How does Tubulointerstitial Fibrosis develop?
disruption of calcium/phosphate homeostasis-deposition in SM cells; uremic toxins cause cells to become like osteoblasts, macrophages adopt proinflammatory state-fibrosis/calcification
How does Vascular Calcification happen? (3)
high intraglomerular capillary pressure; urinary excretion of albumin
_________ impairs the size-selective function of the glomerular
permeability barrier causing an increase in __________.
true
Intraglomerular HTN can lead to systemic HTN. T/F?
RAAS
What is the functional compensatory response of CKD?
declining GFR, Albuminuria
What are the hallmark signs of CKD? (2)
< 3 mg/mmol
What is the normal Albuminuria range?
>30 mg/mmol
What is the Albuminuria range for severely increased?
3-29 mg/mmol
Albuminuria range for moderate increase?
< 15
What is the GFR for kidney failure?
HTN, diabetes
Which disease states increase the risk of CKD? (2)
increase in proteoglycans and advanced glycation end products cause structural changes
How does diabetes cause CKD?
reduce albuminuria, manage HTN/diabetes, prevent secondary complications, manage fluids, review current meds for safety
What are the treatment goals for CKD? (5)