Chronic kidney diseaes

Question 1

serum creatinine influenced by…

Answer 1

sex
age
muscle mass

Question 2

is 24 hr urine collection vs eGFR

Answer 2

no more accurate

Question 3

CKD on ultrasound

Answer 3

• small shrunken kidneys 9 vs 10-13 cm

- increased cortical echogenicity

Question 4

What is the urinalysis like in CKD vs AKI?

Answer 4

Bland urine, with protein

NO ACTIVE SEDIMENT

Question 5

How do you define CKD, 3 conditions

Answer 5

1- eGFR

Question 6

which stage/classification of CKD includes an eGFR greater than 60 but with hematuria/proteinuria/anatomic abnormalities

Answer 6

Stage 1 and 2

Question 7

Stage 3 CKD is now

Answer 7

2 sub classes that include albuminuria

Question 8

3 most common causes of CKD

Answer 8

• diabetic glomeruloscelrosis
• vascular diseases - HTN/ RAS
• Glomerular diseases (primary or secondary)

Question 9

what can you use to delay the progression of CKD?

Answer 9

• ACEi or ARB (rein-2 study)
• statins
• BP control
• smoking cessation
• Glycemic control

Question 10

BP targets without DM vs with DM

Answer 10

• without 140/90

with - 130/80

Question 11

patients with eGFR

Answer 11

NSAIDs, COXIBs, IV contrast

Question 12

should refer to a nephrologist when

Answer 12

eGFR

Question 13

Bone and mineral metabolism complications in patients with CKD

Answer 13

• Hypocalcemia

- Hyperphosphatemia

Question 14

Electrolyte abnormalities in patients with CKD

Answer 14

Hyperkalemia

Metabolic acidosis

Question 15

Uremic abnormalities in patients with CKD?

Answer 15

• N/V
• pruritis
• encephalopathy

Question 16

how does reduced GFR lead to anemia?

Answer 16

• decreased EPO production from peritubular fibroblasts

Question 17

what happens to PTH levels in CKD?

Answer 17

Elevated with Hyperphosphatemia and low calcium - Secondary hyperparathyroidism

Question 18

patients with CKD can present how?

Answer 18

• edema
• N/V
• pericarditis
• Met acidosis
• hyperkalemia

Question 19

what are the goals of dialysis for CKD patients

Answer 19

• Blood purification - solute/toxin removal

- Ultrafiltration - salt and water removal

Question 20

in peritoneal dialysis how do creatinine and urea get removed (diffusion)

Answer 20

by concentration gradients

Question 21

what gets removed through an osmotic gradient in peritoneal dialysis?

Answer 21

• Fluid - due to high glucose in dialysate

Question 22

What is shown to slow the progression to ESRD

Answer 22

ACEi/ARB