2155 Renal & Hepatic Flashcards
CrCl equation
(140-age) x weight x 0.85 (female)
/ 72 x (SCr / 88.4)
Finerenone indication + monitor
indication: T2DM + Albuminuria > 30 mg/day (despite ACE + SGLT2)
Monitor K (<5 = hold)
Metabolic acidosis indication to treat
Serum CO2 < 20-22
PO/IV Sodium Bicarbonate
TSAT formula
serum Fe / TIBC x 100%
ESA start & stop criteria + caution (2)
Hgb < 10 g/dL, stop if Hgb > 13
Caution: Hx of malignancy & stroke
ESA’s ADR (3)
- Pure red cell aplasia
- HTN
- Vascular access thrombosis
Iron supplement start criteria (2)
TSAT < 30% & Serum ferritin < 500 ng/mL
Iron supplement (PO & IV) ADR (4)
- Anaphylaxis (CV collapse, respiratory complication)
- GI (dark stool, N, cramps)
- Fe overload (liver, pancreatic, cardiac dysfunction)
- increase risk of infection (hold off)
Corrected Ca formula
measured Ca + 0.02 x (40- serum albumin)
Administration of phosphate binders (3)
- take with meals, swallow whole
- Limit phosphate intake to 800-1000 mg per day
- separate 2-3h apart from other drugs
Ca supplement ADRs (3)
–> limit to 2g elemental /day
- Hypercalcemia (stop)
- Constipation, N/V
- urolithiasis (kidney stone)
Phosphate binders DDI (3)
- Fluoroquinolones
- Levothyroxine
- Antiepileptic
Spironolactone / Furosemide ADR
- AKI
- Hypo Na / K
- Gynaecomastia (spiro)
- Hepatic Encephalopathy
Drugs to avoid in ascites (2)
NSAIDs
ACEI & ARB
Treatment of Hepatic Encephalopathy (2)
PO Lactulose 30-45 mL BD/TDS
PO Rifaximin 550 mg BD
Treatment of NAFLD
PO Pioglitazone 30 mg OD for 2 months (with aggressive statin)
PDL1 inhibitor (Bevacizumab) ADR (2)
- Immune-related adverse event
- Bleeding & disturbed wound healing
