Chronic Kidney Disease

Question 1

CKD Staging GFR category

Answer 1

G1: > 90
G2: 60 - 90
G3a: 45 - 60
G3b: 30 - 45
G4: 15 - 30
G5: < 15 (ESKD)

Question 2

CKD Staging Albuminuria category

Answer 2

A1: > 3
A2: 3 - 30
A3: > 30

Question 3

What is CKD?

Answer 3

abnormal kidney function for over three months, with either a decreased glomerular filtration rate (GFR), (below 60 ml/min/1.73m2) or markers of kidney damage

Question 4

BP target CKD w/ urine ACR
< 70

Answer 4

< 140/90 mmHg

Question 5

BP target for CKD w/ ACR > 70, and DM patients w/ proteinuria

Answer 5

< 130/80 mmHg

Question 6

Hb target in CKD patients

Answer 6

100 - 130

Question 7

Mx in proteinuria

Answer 7

ACE-i OR ARBs

Question 8

What complication is the most common cause of death in CKD?

Answer 8

Cardiovascular disease

Question 9

CRF HEALS

Complications of CKD

Answer 9

Cardiovascular disease
Renal osteodystrophy
Fluid (oedema)
Hypertension
Electrolyte disturbance (hyperkalaemia, acidosis)
Anaemia
Leg restlessness (uraemia)
Sensory neuropathy (uraemia)

Question 10

Mx for metabolic acidosis in CKD

Answer 10

PO Sodium bicarb

Question 11

Mx for hyperphophataemia in CKD

Answer 11

Phosphate binders: Calcium acetate

Question 12

Mx for hypocalcaemia in CKD

Answer 12

alfacalcidol

Question 13

Bicarbonate target in CKD

Answer 13

more than 22

Question 14

Mx for Anaemia in CKD

Answer 14

EPO injection
IV iron

Question 15

Nephrology referral criteria

Answer 15

1. Decrease >25% eGFR OR change in eGFR category in 12/12
2. Decrease eGFR of 15/more in 12/12
3. Resistant HTN on 4 agents
4. urine ACR >30 w/ haematuria
5. urine ACR >70 w/out DM
6. > 5% in 5-year risk of needing kidney replacement therapy (dialysis/tranplant)

Question 16

When to start ACE-i OR ARBs in CKD?

Answer 16

For patitent:
- HTN w/ ACR >30
- DM w/ ACR >3

Titrate to highest tolerated dose

Question 17

When to offer Atorvastatin 20mg in CKD?

Answer 17

To all people with CKD

Question 18

When to offer SGLT-2 inhibitor to CKD pts?

Answer 18

1. People with T2DM + persistent proteinuria(>3) who are taking max. tolearated dose of ARB or an ACE-i
2. People with eGFR 25-75 + ACR >22.6

Question 19

What time of the day should be ACR be performed?

Answer 19

Morning Urine ACR

Question 20

How many eGFR readings < 60 is required to determine CKD?

Answer 20

3 readings of egfr < 60

Question 21

What is the timeframe for eGFR testing for pt w/ egfr < 60?

Answer 21

14 days and then 90 days from the 1st eGFR test

Question 22

What monitoring should be offer to pt w/ HTN + eGFR of 60

Answer 22

Annual U+Es
ACR

Question 23

How many ACR readings is required to confirm proteinuria?

Answer 23

2 ACR readings of >3

Question 24

When to use the kidney failure risk equation for patient?

Answer 24

Confirmation of abnormal proteinuria

Question 25

What + When to monitor after ACE-i/ARB initiation

Answer 25

2/52 after initiation