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Skip to 0 minutes and 14 seconds So the kidney function will actually close to the associations with the two systems that we mentioned previously. So elimination of fluid and electrolytes and also body waste to keep the balance of acid bases in the body is one way many major part of a kidney function and also some important factors actually also related to the body system. The first thing is about Endocrine, Erythropoietin that’s actually generated in kidney. So when kidney had very decreased function the endocrine function for EPO generation were decreased.

Skip to 1 minute and 6 seconds So the patient may have anemia and also some other issues about their body system and also kidney is responsible for activation of vitamin D and therefore follows patient with decreased kidney function those patients will have a bone issue and also concurrently with the electrolyte imbalance the patient will have a various serious issues about their bone. And so the clinical presentation of CKD naturally includes a lot of different systems body systems function.

Skip to 1 minute and 49 seconds So cardiovascular disease will actually related to those symptoms and size for CKD So the patient may have a very bad left ventricular hypertrophy and therefore the patient has low cardio output and then those patients were actually has edema in the alack and also pulmonary edema and because there are a lots of accumulation of testing so the patient will have nausea and vommiting and also uremic bleeding and due to those nephrotics testing restless leg syndrome will happen and also as we mentioned about EPO anemia and the platelet dysfunction will be occurs and skeletal issue as important as vitamin activation, was actually decreased and thus Renal osteodystrophy will actually occurred in the same time with electrolyte imbalance and also endocrine is a big issue.

Skip to 3 minutes and 6 seconds The patient may have a hypothyroidism and hyperglycemia that’s lukayla definition of CKD. There are a lot of a different stages and the first thing as one with patient with CKD risk factors and they have normal eGFR The adult patient can actually be staging as at increasing risk but without effectively number but we always need to remember for all patient with hypertension and also diabetes continued and monitoring periodically, monitoring for the kidney function is very important.

Skip to 3 minutes and 54 seconds And the patient staging stage one they will have actually very normal eGFR function but actually has some minor kidney damage that not able to be detected very easily and from stage two to five, we use some points, cut points of eGFR including 60, 30 and 15 for staging of all these these stages.

Clinical presentation & stages of CKD

In this step, Prof. Chen gives a lecture on major functions, clinical presentation and definition of CKD.

To begin with, the kidneys have three major functions: elimination, endocrine, and metabolic. When the kidneys’ function decreases, the endocrine function for EPO generation will decrease, making patients have anemia or other issues of their body system.

Besides, we need to know the symptoms of CKD, including pulmonary edema, restless leg syndrome, anemia, hypothyroidism and hyperglycemia. These can help us know that the patients may have CKD.

Finally, the definition and staging of CKD are significant. In the first stage, patients have normal eGFR function, but actually have some undetected minor kidney damage.

However, from stage two to five, we use some cut points of eGFR to distinguish these stages.

How do you tell the stage of CKD in clinical practice? Please share your experience below.

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This video is from the free online course:

Pharmacokinetics: Drug Dosing in Renal Disease

Taipei Medical University