Chronic Kidney Disease Flashcards
Chronic renal failure is the same thing as ______ kidney disease.
Chronic
Chronic kidney disease (CKD) is _________.
Progressive
2 main risk factors for CKD:
Diabetes
Hypertension
1/2 of CKD patients also have ______, due to uncontrolled glucose levels damaging the glomeruli.
Diabetes
1 in ____ people with hypertension, will eventually develop CKD.
5
Hypertension puts extra ________ on the vessels of the glomeruli, creating more resistance and damage.
Pressure
Other risk factors of CKD:
Glomerulonephritis (rare)
Age
Family history
Ethnicity: African Americans and American Indians
Prevention of CKD:
DASH diet
Mediterranean diet
Plant based diet
- Helps regulate blood pressure and sugar and also reduce acid load on kidneys
GFR Calculation
Age
Race
Gender
Serum creatinine level
T/F: Stages 1- 3 of kidney disease often have no symptoms.
True
___________ in a basic metabolic panel will indicate GFR function. As it increases, GFR decreases.
Creatinine
At stages 1-3, a __________ test will help detect CKD because as kidneys become damage, protein will leak into the urine.
Microalbumin
_______ is the amount of albumin in the urine.
Albuminuria
T/F: A microalbumin test will help detect early kidney disease due to the smaller amounts of albumin leaked in the urine.
True
CKD is characterized by:
Proteinuria
Azotemia
Proteinuria
Increased urine albumin
Azotemia
Increased nitrogenous waste products - BUN and creatinine
Serum albumin _____ and urine albumin ______ since we are leaking albumin from the blood, into the urine.
Decreases, increases
Serum sodium levels ______ since CKD patients have fluid overload, diluting the sodium in the blood.
Decrease
T/F: Serum sodium is a better indicator of fluid status, rather than sodium status.
True
Fluid overload ____ serum sodium concentrations.
Dilutes
Serum potassium and phosphorus _____ because the kidneys cant excrete these minerals in the urine.
Increases
T/F: Potassium, phosphorus and sodium all highly affect fluid status.
F, only sodium
Monitoring for CKD:
- Fluid intake
Intake > outputs (positive) - Edema
- Weight is affected by fluid, ask for UBW or dry weight
MNT for CKD (pre dialysis)
- Higher energy needs to spare protein
35 kcals/kg IBW - Protein depends on GFR
0.6 - 1 g/kg - Sodium restriction
- Potassium depends on urine output and serum levels
- Phosphorus
T/F: We want patients to use protein for energy, therefore increase protein
F, we want to decrease protein and consume adequate calories for fuel
If GFR is less than 25, protein needs are:
0.6 - 0.8 g/kg
If GFR is more than 25, protein needs are:
0.8 -1 g/kg
The lower the GFR, the ____ protein the patient can consume.
Less
Sodium restriction to lower BP, reduce fluid retention, and prevent excess urinary ______ excretion.
Protein
Low urine output and high serum levels may warrant a potassium _________.
Restriction
Potassium should only be limited if necessary, because ______ foods are protective against kidney disease.
Plant
T/F: Phosphorus should be limited in CKD.
True and must be limited early on in the disease
Phosphorous sources:
MFP
Dairy
Legumes
Soda
Processed foods high in phosphates
Nuts and seeds
Whole grains
T/F: Phosphorus must be restricted to no more than 0.8-1.2 g/day
True
T/F: Patients should limit phosphorous foods such as dairy and legumes as they are low biological value and consume MFP instead as they are high biological value.
True
Since the mineral is widely found in food, patients can take _________ binders, which are a medication taken with meals that binds with phosphorus in food or the GI tract to prevent absorption.
Phosphate binders
T/F: Patients taking phosphate binders can consume as much phosphorus containing foods that they want.
False, they must also limit phosphrous containing food
Probiotics and _______ should be consumed since waste products wreak havoc on the gut but they also lower ammonia levels.
Prebiotics
Types of phosphate binders:
Renvela
Phoslo
Stage 1 of CKD
“Normal GFR”
90 ml/min
Stage 2 of CKD
Mild CKD
60 - 89 ml/min
Time to ask the doctor for a microalbumin test to diagnose early kidney disease
Stage 3 of CKD
Moderate CKD
30 - 59 ml/min
Stage 4 of CKD
Severe CKD
15-29 ml/min
Begin hemodialysis
Stage 5 of CKD
End-stage/Kidney failure
Less than 15 ml/min
________ levels are measured in a basic metabolic panel.
Creatinine
