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Renal > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

What GFR range is classified as stage 1

A

mor or equal than 90

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2
Q

What stage of CKD is GFR range of 60-89

A

2

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3
Q

what stage of CKD is GFR rate of 30-59

A

3

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4
Q

what stage of CKD is GFR of 15-29

A

4

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5
Q

what stage of ckd is GFR <15

A

5

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6
Q

what stage of CKD is classified as renal failure

A

stage 5

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7
Q

what stage of CKD would you prepare for renal replacement therapy

A

4

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8
Q

what is the definition of CKD

A

either functional or structural
kidney damage or a glomerular filtration
rate (GFR) less than 60 mL/min per
1.73m2
for at least 3 months

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9
Q

3 MAIN causes of CKD

A

type 2 DM, HPT, HIV

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10
Q

What medication is causing ckd

A

PPI (proton pump inhibitor)

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11
Q

how long after diabetes diagnosis are patients at risk of getting diabetic nepropathy

A

15-25 yrs

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12
Q

Are kidneys in diabetic patients hyper/hypofiltrating

A

hyper

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13
Q

what feature does some HIV patients with CKD get

A

proteinuria (around 5%)

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14
Q

what is the primary prevention of CKD

A

healthy lifestyles in terms of Obesity, smoking, hpt. Educational programmes also help

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15
Q

How do you implement/promote healthy lifestyles

A

healthy eating in school, compulsory sport, anti-smoking campaigns, PREVENT HIV

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16
Q

What should be done at a community health care centre for early detection

A

Routine BP checks, glucose checks for tho those at risk for DM, voluntary HIV testing

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17
Q

what is the goal BP for patients + DM patients to reduce risk

A

Normal patients: <140/90, DM <130/80

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18
Q

what should the HBA1C% be

A

<7%

19
Q

what should the fasting glucose be in screening tests

A

<7mmol/L

20
Q

when should statin therapy be considered when screening

A

if LDL is more than 3 mmol/L or total cholesterol>5mmol/L

21
Q

what patient profiles should have dipsticks as screening tests and how often

A

diabetics, hpt, HIV+, >65. They should have it anually

22
Q

what test should diabetics with negative proteinuria test on dipsticks have

A

spot urine test for microalbuminuria

23
Q

what 2 characteristics are needed to classify CKD

A

GFR<60 and/or overt proteinuria/haematuria

24
Q

what characteristic do diabetics need on spot urine test to be in early CKD

A

microalbuminuria

25
Q

what spot urine result is classified as microalbuminuria?

A

ratio between 3-30

26
Q

what spot urine ratio is classified as macroalbuminuria

A

> 30

27
Q

Where is CKD-EPI more accurate in staging CKD

A

stages 4/5

28
Q

why is CKD-EPI/ MDRD more convenient?

A

no need for patient weight

29
Q

what staging system is better at normal GFR?

A

cockcroft-gault equation

30
Q

How can you slow progression in CKD stage 1/2

A

Treat the primary causes of CKD:

Treat BP: <130/80

Treat proteinuria: <1g/day by using ACE-I/ARB

Treat hyperlipidaemia: LDL<3mmol/l or less if having IHD

Treat Glucose: HBA1C <7% but not less than 6.5%

Lifestyle modifications: nutritional diet, stopping smoking, exercise

31
Q

How should you slow progression at stage 3

A

Limit increase in phosphate/PTH by:
- low phosphate diet
- phosphate binders
- Vitamin D
- Calcimimetics

32
Q

slowing progression of stage 4/5

A

treat anaemia:
- exclude iron def anaemia by looking for ferritin <100/transferrin sats <20%

erythropoeisis stimulating agents

keeping Hb between 10-12

If bicarbonate <20mmol/L it must be treated with NaBic

33
Q

why is bicarbonate supplementation beneficiary

A

slows rate of progression + improves nutrtional status

34
Q

what is latest that you should refer CKD to nephrologist

A

stage 4

35
Q

what are the 3 options included in renal replacement therapy

A

hemodialysis
peritoneal dialysis
transplantation

36
Q

how often should haemodialysis be done?

A

4 hours 3x weekly/ Nocturnal for 6-8hrs

37
Q

Is peritoneal dialysis continuous of intermittent

A

continuous

38
Q

when do they take a kidney from a deceased donor

A

after brain death, after circulatory

39
Q

Which formulas are no longer used to calculate eGFR?

A

Cockcroft-Gault

40
Q

Patients should be referred to a nephrologist once the eGFR drops below:

A

30ml/min

41
Q

Iron supplementation in CKD is targeted to Ferritin levels in the following range:

A

200 - 500ug/L

42
Q

What is the MOST COMMON form of anaemia seen in patients with CKD?

A

Normocytic normochromic anaemia

43
Q

Which phosphate binders are no longer much used because of safety concerns?

A

Aluminium Hydroxide

44
Q

The best form of renal replacement therapy is:

A

Kidney Transplantation

Renal (5 decks)

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