Preparatory Mindset

CKD is PROGRESSIVE and IRREVERSIBLE. The leading causes are diabetes and hypertension. GFR staging determines management. Complications include anemia (↓ erythropoietin), renal osteodystrophy (↓ vitamin D, ↑ phosphate), metabolic acidosis, and uremia. Dialysis or transplant is needed at end-stage (GFR <15).

Core Concepts

• CKD = progressive, irreversible ↓ in GFR over months-years.


• Causes: diabetes (leading cause), hypertension, glomerulonephritis.


• GFR stages: 1 (≥90, normal), 2 (60-89, mild), 3 (30-59, moderate), 4 (15-29, severe), 5 (<15, ESRD).


• Complications: anemia (↓ EPO → fatigue), renal osteodystrophy (↓ vitamin D → hypocalcemia → ↑ PTH → bone disease), metabolic acidosis, hyperkalemia, uremia (nausea, pruritus, pericarditis, encephalopathy).


• Treatment: control BP (ACEi/ARBs), slow progression, manage complications, dialysis or transplant at ESRD..

High-Yield Points

• GFR staging: Stage 1 (≥90), Stage 2 (60-89), Stage 3 (30-59), Stage 4 (15-29), Stage 5 (<15)


• Complications: anemia (↓ EPO → treat with EPO), renal osteodystrophy (↓ vitamin D, ↑ phosphate), metabolic acidosis


• Uremic symptoms: nausea, pruritus, pericarditis, encephalopathy


• Dialysis indications: refractory hyperkalemia, volume overload, uremia, severe acidosis

Topic Summary

CKD progresses through stages based on GFR. Diabetes and hypertension are the leading causes. Key complications: anemia, renal osteodystrophy, metabolic acidosis, uremia. ESRD requires dialysis or transplant.