SECTION 1

Kidney Disease Questions

All questions below are mandatorywith diagrams were necessary

Question 1. Describe anatomy and physiology of normal kidney function, common pathologies, and the difference between AKI and CKD. What role does the laboratory play in the implementation of NICE/KDIGO guidelines for the management of AKI and CKD.(1300 words with diagram were necessary)

Question 2. What do the terms oliguric and anuric mean?(200 words)

Question 3. Describe how urine albumin can be used in the assessment of chronic kidney disease and diabetic nephropathy(300 words)

Question 4. What calculations can be used to estimate Glomerular Filtration Rate (GFR) including in children? What do you need to consider and take care when using these calculations?(800 words)

Question 5. What effects does renal disease have on the following analytes:
• Potassium
• PTH
• Vitamin D
• Haematinics.(500 words)

Answer any 5 of the following questions with diagrams were necessary

Q1. What exogenous markers can be employed to measure GFR?(250 words)

Q2. What methods can be used to measure urinary total protein - discuss pros and cons, include test strips used in point of care testing (POCT)/community?(300 words)

Q3. What are the causes of acute and chronic kidney disease?(300 words)

Q4. What role does microalbumin play in the diagnosis of kidney disease, particularly in Diabetics. (300 words)

Q5. What methods are available to measure protein in urine within the laboratory and POCT?(300 words)

Q6. What other urine tests can be measured to assess tubular function and why (including urinephosphate, urine glucose, pH and specific proteins) (400 words)

SECTION 2

Reflective Log
This section is used to demonstrate you can relate knowledge from several areas, draw conclusions and reflect on your own performance as an independent professional learner.

1. Summarise the laboratory role in the previous section(s):(200 words)
Your understanding of how the laboratory operates within this section?

2. Personal reflection on training: (200 words)
What have you learnt?
How can you use what you have learnt?
How could this benefit the service user? Example, patients, Clinicians and healthcare providers?

GUILDELINE
SCOPE: YOUR ANSWERS MUST COVER THIS AREAS FOR SECTION 1
KNOWLEDGE:

The candidate is expected to be able to demonstrate knowledge and understanding of the following:

1. Basic anatomy and physiology of normal kidney function and common pathologies that may arise including the differences between acute kidney injury (AKI) and chronic kidney disease (CKD).

2. Investigations that are indicators of glomerular filtration rate (GFR), specifically plasma or serum creatinine, urea and cystatin C, and their analytical and clinical limitations.

3. Deriving a calculated/estimated GFR, including creatinine clearance, the ckd-epi equation and other equations that may be applied locally, including those appropriate to children.

4. Additional analyses, measures and variables that are required in the calculation of GFR, for example urine creatinine, timed urine volume, subject age, gender, ethnicity, height and weight depending on the GFR calculation applied.

5. Reference GFR procedures that use exogenous markers (e.g. chromium EDTA or iohexol clearance).

6. Methods available to measure urinary protein (including urine test strip methods) and their relative merits.

7. How urinary albumin can be used in monitoring kidney disease and its specific application for the assessment of diabetic nephropathy.

8. Analyses in urine that may be used to assess renal tubular function including urine phosphate, glucose, pH and specific proteins.

9. Effects of renal disease on a range of biochemical analyses other than those specifically listed above, for example plasma potassium, PTH, vitamin D and haematinic investigations.

10. Categorisation of chronic kidney disease stages based on clinical findings and GFR values.

11. Calculation and clinical utility of the Acute Kidney Algorithm

12. Role of the laboratory in implementing clinical practice guidelines for the management of AKI and CKD (e.g. NICE*, KDIGO*).