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Table of Contents
Introduction
The purpose of the book
understanding the natural history of kidney disease
how displaying a GFR history is a fundamental part of the clinical assessment of kidney diseases
how the eGFR graph is used to inform patients and plan treatment.-principles but not details of treatment
The basics of creatinine measurement and eGFR equations in adults
Simple guide to the classification of AKI, AKD and CKD
Stages of CKD
including proteinuria
The meaning of 'stability' in an eGFR graph
variation over time
Cases
Section 1: Acute kidney injury
changes over 50% drop, assuming no asymmetry)
Recurrent AKI leading to CKD
Section 2: AKD
changes>48 hours 3months
Patterns of progression
Linear and Non-linear
Monitoring response to treatment
e.g. immunosuppression for GN, BP control in malignant hypertension
Section 4: CKD
changes over years
non-progressive (stable) CKD
e.g. obstructive uropathy
progressive CKD
e.g. transplant nephropathy, lithium nephrotoxicity, role of proteinuria as risk marker
Use of graphs to plan future renal replacement therapy
e.g. linear progression in ADPKD
Section 5: Acute-on-chronic kidney disease
Chronic slowly progressive diabetic nephropathy with superimposed acute pathology, e.g. response to ACEI/ARB, contrast nephropathy, glomerulonephritis, interstitial nephritis
Transplant rejection
Pregnancy in women with CKD
Section 6: Nephrotic syndrome
GFR, serum albumin and urinary PCR graphs
use to monitor treatment and relapses, and to plan treatment
Section 7: Other graphs
24 hour BP measurement
importance of nocturnal dip and timing of antihypertensives in CKD care
Diabetes mellitus
HbA1c
colour coding as patient education tool; role of glucose control in preventing diabetic nephropathy (but no impact once CKD established)
Serum free light chains and myeloma kidney/light chain nephropathy/immune GN
Conclusions
eGFR graphs
an essential tool in patient assessment which tells the story of kidney disease
The role of graphs (eGFR, 24 hour BP, and HbA1c) in patient education and support of self-management
Role of eGFR graphs in systematic CKD surveillance by renal units and pathology labs
evidence of benefit.
The purpose of the book
understanding the natural history of kidney disease
how displaying a GFR history is a fundamental part of the clinical assessment of kidney diseases
how the eGFR graph is used to inform patients and plan treatment.-principles but not details of treatment
The basics of creatinine measurement and eGFR equations in adults
Simple guide to the classification of AKI, AKD and CKD
Stages of CKD
including proteinuria
The meaning of 'stability' in an eGFR graph
variation over time
Cases
Section 1: Acute kidney injury
changes over 50% drop, assuming no asymmetry)
Recurrent AKI leading to CKD
Section 2: AKD
changes>48 hours 3months
Patterns of progression
Linear and Non-linear
Monitoring response to treatment
e.g. immunosuppression for GN, BP control in malignant hypertension
Section 4: CKD
changes over years
non-progressive (stable) CKD
e.g. obstructive uropathy
progressive CKD
e.g. transplant nephropathy, lithium nephrotoxicity, role of proteinuria as risk marker
Use of graphs to plan future renal replacement therapy
e.g. linear progression in ADPKD
Section 5: Acute-on-chronic kidney disease
Chronic slowly progressive diabetic nephropathy with superimposed acute pathology, e.g. response to ACEI/ARB, contrast nephropathy, glomerulonephritis, interstitial nephritis
Transplant rejection
Pregnancy in women with CKD
Section 6: Nephrotic syndrome
GFR, serum albumin and urinary PCR graphs
use to monitor treatment and relapses, and to plan treatment
Section 7: Other graphs
24 hour BP measurement
importance of nocturnal dip and timing of antihypertensives in CKD care
Diabetes mellitus
HbA1c
colour coding as patient education tool; role of glucose control in preventing diabetic nephropathy (but no impact once CKD established)
Serum free light chains and myeloma kidney/light chain nephropathy/immune GN
Conclusions
eGFR graphs
an essential tool in patient assessment which tells the story of kidney disease
The role of graphs (eGFR, 24 hour BP, and HbA1c) in patient education and support of self-management
Role of eGFR graphs in systematic CKD surveillance by renal units and pathology labs
evidence of benefit.