Which of the following phenomena would you expect to see in someone with Chronic Kidney Disease?

Options:
explanation: These are all features you would expect to see in someone with Chronic Kidney Disease (CKD).

CKD is a disease where there is a reduction in kidney function - kidney failure. You would expect to see filtration failure in the kidneys, resulting in proteinuria and haematuria.

The kidneys are also responsible for controlling blood pressure through the regulation of salt. Decreased kidney function causes the body to retain more water, leading to high blood pressure (hypertension).

The kidneys are also responsible for producing erythropoietin (EPO), which is a hormone that stimulates haemoglobin synthesis. Without adequate EPO production, insufficient haemoglobin (Hb) is produced, leading to anaemia (low Hb levels in the blood).

The kidneys are important in the synthesis of Vitamin D too - they are where 1-alpha-hydroxylation of Vitamin D occurs. This step is vital - without it Vitamin D is inactive, and cannot be used in the body, leading to a Vitamin D deficiency.
name: Hypertension, Vitamin D Deficiency, Anaemia
label: a
answer: yes
explanation: These symptoms are sometimes described as lower urinary tract symptoms (LUTS). These are commonly found in disorders affecting the lower urinary tract - the bladder and urethra.

In Chronic Kidney Disease (CKD), you would expect to find symptoms of kidney filtration failure. These include proteinuria, hypoalbuminaemia, haematuria, hypertension, vitamin D deficiency and anaemia.
name: Increased urinary frequency, difficulty starting urination, poor urinary stream
label: d
answer: no
explanation: Peripheral oedema refers to swelling of the ankles and feet. Ketonuria refers to the presence of glucose in the urine. Ketonuria is most commonly found in patients with Type I Diabetes Mellitus, in a complication known as Diabetic Ketoacidosis (DKA). During DKA, the body released ketones as it is unable to absorb any glucose, resulting in ketonuria when these ketones are expelled from the body. You would not expect to see this in someone with CKD.

CKD is a chronic condition that occurs when the kidneys are unable to filter substances effectively. This can lead to anaemia, vitamin D deficiency, proteinuria, haematuria, hypertension and peripheral oedema.
name: Peripheral oedema, foamy urine, ketonuria
label: e
answer: no
explanation: Renal colic is a severe and fluctuating pain, often described as radiating from 'loin to groin'. It is most commonly caused by the presence of a renal stone lodged in the ureters.

This would also cause haematuria, as the stone would damage the epithelial cells of the ureters, and painful urination in the ureters spasm.

These symptoms would not be found in Chronic Kidney Disease (CKD), which is a chronic condition where the kidneys fail to filter substances. This condition is associated with proteinuria, hypoalbuminaemia, haematuria, hypertension, vitamin D deficiency and anaemia.
name: Renal colic, haematuria, painful urination
label: c
answer: no
explanation: Fever, nausea and pain are often symptoms of infection. Flank pain suggests pain of renal origin, such as pyelonephritis.

In Chronic Kidney Disease (CKD), the kidneys gradually fail and are unable to filter substances properly. It is not due to infection - therefore, you would not expect to see these symptoms in a CKD patient.
name: Fever, nausea, flank pain
label: b
answer: no

Correct answer: a