Chronic Kidney Disease

Question 1

hematuria

Answer 1

Blood in urine

Question 2

Azotemia

Answer 2

Toxins, lack of kidney filtration

Question 3

oliguria

Answer 3

Decreased urine output
<400 ml/day

Question 4

glomerular filtration rate

Answer 4

Lab that test amount of blood being filtered by glomeruli

Question 5

kidney function

Answer 5

Maintain fluid and electrolyte homeostasis

Get rid of water, soluble waste via urine

Produces erythropoietin – RBC production

Activate vitamin D

Produces renin – regulates BP

Question 6

Normal BUN level

Answer 6

10-20

Question 7

normal Cr level

Answer 7

0.5-1.2

Question 8

normal BUN/Cr

Answer 8

10:1

Question 9

normal GFR

Answer 9

> 90 ml/min

Question 10

chronic kidney disease

Answer 10

Presence of kidney damage >3 months with or without GFR <60

In ability to maintain acid base balance, remove end products of metabolism, maintain fluid/electrolyte balance

Question 11

stage one of CKD

Answer 11

Kidney damage with normal or increased GFR

> = 90

Question 12

symptoms of stage 1

Answer 12

Asymptomatic

Question 13

Stage two of CKD

Answer 13

damage with mild, decreased GFR

60-89

Question 14

symptoms of stage two

Answer 14

Asymptomatic, HTN, possibly

Question 15

stage three of CKD

Answer 15

Moderate decrease GFR

30-59

Question 16

symptoms of stage three

Answer 16

Hypertension

Question 17

stage four of CKD

Answer 17

Severe decreased GFR

15-29

Question 18

what stage of CKD are symptoms apparent?

Answer 18

Stage four

Question 19

stage five of CKD

Answer 19

End stage renal failure

<15

Question 20

symptoms of stage five

Answer 20

Uremia

Question 21

Causes of end-stage renal disease

Answer 21

1 diabetes

HTN
Glomerular nephritis

Question 22

risk factors of CKD

Answer 22

Family history
>60 yrs old
Male, AA
HTN, diabetes, smoking
Overweight, obese

Question 23

pathogenesis of CKD

Answer 23

Glomerulosclerosis – scar tissue
Interstitial fibrosis
Interstitial inflammation

Complement – further destruction of kidney disease

Angiotensin II - increased BP

Question 24

uremia

Answer 24

Retention of metabolic wastes

Urea, phenols, Cr, hormones, electrolytes, water

Question 25

what GFR value relates to uremia?

Answer 25

<=10

Question 26

what occurs when the kidneys No longer maintain fluid and electrolyte homeostasis?

Answer 26

Edema
Hyperkalemia
Hyperphosphatemia
Hypermagnesemia
Metabolic acidosis

Question 27

What occurs when the kidneys no longer rid the body of waste via urine?

Answer 27

anorexia
Malnutrition
Itching
CNS changes – confusion

Question 28

what occurs with decreased production of erythropoietin?

Answer 28

Anemia

Question 29

what occurs with decreased activation of vitamin D?

Answer 29

Renal osteodystrophy
Weak bones - risk for fractures!

Question 30

what does pharmacology therapy do?

Answer 30

Slows rate of progression
Reduce BP to <140/90
Treat HDL <200

Question 31

how to treat volume overload

Answer 31

Loop diuretics, low sodium diet

Question 32

how to treat hyperkalemia

Answer 32

Decrease foods, high in potassium

Question 33

how to treat hyperphosphatemia

Answer 33

Calcium carbonate

Question 34

how to treat metabolic acidosis

Answer 34

Sodium bicarb

Question 35

how to treat renal osteodystrophy

Answer 35

Calcitriol
Vitamin D

Question 36

how to treat anemia

Answer 36

Erythropoietin if Hgb <10

Question 37

how to control high blood pressure

Answer 37

ACE/ARB

Question 38

how to control lipids

Answer 38

Statins

Question 39

Complications of drug therapy

Answer 39

many drugs are excreted through the kidneys. – Renal dosing

decreased drug elimination

Drug dosage and frequency adjusted