Chronic Kidney Disease

Question 1

Intervention to preserve residual kidney function:

Answer 1

Avoid nephrotoxins
Avoid hypovolaemia
PD as initial dialysis option - avoidance of PD peritonitis
RAAS blockade
HTN control
Maintainence of transplant immunosuppression

Question 2

Onset of diabetic nephropathy in Type 1 DM

Answer 2

5-15 years (and usually associated with diabetic retinopathy)
Generally at 10 years for Type II (but can be present at diagnosis)

Question 3

Definition of macroalbuminuria in men vs women:

Answer 3

Men: urine ACR >25mg/mmol, AER >300mg/24 hours
Women: urine ACR >35 mg/mmol, AER >300mg/24 hours

Question 4

Interventions to slow the progression of diabetic nephropathy

Answer 4

1. BP control
2. ACE inhibitors
3. Glycaemic control
4. Smoking cessation
5. Lipid control

Question 5

Drugs that can be cleared by haemodialysis

Answer 5

BLAST 
Barbiturates 
Lithium 
Alcohol (ethylene glycol, methanol) 
Salicylates
Theophylline