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Module 1: Understanding Chronic Kidney Disease (ckd)The kidneys have many functions
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səhifə | 8/18 | tarix | 25.05.2022 | ölçüsü | 2,76 Mb. | | #87833 |
| Diet Module 1 2019 - Endocrine function
- Produce renin for blood pressure control
- Produce erythropoietin which stimulates marrow production of red blood cells
- Activate 25(OH)D to 1,25 (OH)2D (active vitamin D)
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- Metabolic function
- Gluconeogenesis
- Metabolize drugs and endogenous substances (e.g., insulin)
CKD usually means fewer functioning nephrons Fewer nephrons disrupt the balance - Urine volume may not change
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- Reduced waste excretion
- May not be apparent until CKD is advanced
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- Altered hormone production
- Anemia (erythropoietin) and mineral & bone disorders (vitamin D) may develop
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- Reduced catabolism
- Examples: Insulin, glucagon, drugs
Fewer nephrons disrupt the balance - Reduced renal clearance and accumulation of:
- Advanced glycation end products
- Pro-inflammatory cytokines
- Reactive oxygen species (oxidation)
- Metabolic acids
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- Insulin resistance (even in people without diabetes)
- Reduces insulin-mediated glucose uptake in skeletal muscles
- May be associated with inflammation
- Identify and monitor CKD
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- FUNCTIONAL ASSESSMENT
CKD is reduced kidney function and/or kidney damage - Chronic Kidney Disease
- Kidney function
- Glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 for > 3 months with or without kidney damage
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- Kidney damage
- > 3 months, with or without decreased GFR, manifested by either
- Pathological abnormalities
- Markers of kidney damage, i.e., albuminuria
- Urine albumin-to-creatinine ratio (UACR) > 30 mg/g
- Reference: Kidney International Supplements, 2013; 3(1): 5-14
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