chronic kidney disease Flashcards

1
Q

3 ways to help diff. AKI from CKD

A
  1. Hx/Px
  2. labs
  3. investigations
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2
Q

parts of Hx/Px

A
  • ROS
  • chronic diseases
  • Pmhx
  • new meds
  • family Hx
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3
Q

what does previos Cr tell you

A

need to establish a baseline
- previosly high - chronic
previously normal - acute

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4
Q

2 alternatives to Cr

A
  1. eGFR

2. 24 hour urine

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5
Q

2 investigations that might be helpful

A
  1. US
    - small and shrunken in CKD
  2. urinalysis
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6
Q

def. of CKD (3)

A
  1. kidney damage or eGFR
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7
Q

how many stages of CKD

A

5

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8
Q

2 main classification of kidney disease

A

diabetic vs. non-diabetic

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9
Q

3 most common causes of CKD

A
  1. diabetes
  2. vascular disease
  3. glomerular disesase
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10
Q

what is new focus in CKD

A
  1. early diagnosis and intervention

2. focus on CKD like a CHD risk level

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11
Q

what is survivia;

A
  • most die of heart disease

- poor surival

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12
Q

what is step 1

A

think about a ACEi or ARB

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13
Q

what is step 2

A

tight blood pressure control

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14
Q

step 3

A

use a statin to target LDL

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15
Q

step 4

A

smoking cessation

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16
Q

step 5

A

optimize glycemic control

17
Q

step 6

A

patients with eGFR

18
Q

2 times when need to refer to a nephro

A
  1. rapid deterioration in kidney function as defined by eGFR

2. or eGFR

19
Q

what is relationship between CKD and anemia

A

low GFR>low EPO> anemia

20
Q

what is relationship between CKD and bone metabolism

A

Due to secondary hyperparathyoidism

  1. skeletal effects
  2. non-skeletal
    - calc. of arteries
    - skin ulcers
    - prurutis
21
Q

4 indication for dialysis

A
  1. persistent metabolic distubances
  2. fluid overload refractory to diuretics
  3. progressive uremia
  4. pericarditis
22
Q

4 indication for dialysis

A
  1. persistent metabolic distubances
  2. fluid overload refractory to diuretics
  3. progressive uremia
  4. pericarditis
23
Q

2 goals of dialysis

A
  1. solute/toxin removal (purification)

2. salt and water removal (ultrafiltration)

24
Q

difference between 2 dyalisysis choices

A

none- patient pref

25
Q

what is hemodyalisis

A

required IV access with a tunneled catheter

26
Q

what is peritoneal dyalisis

A

fluid exchanced through the perioneum

27
Q

2 types of pertioneal

A
  1. continuous abulatory
    - put in bag and walk around - change every few hours
  2. continuous cyclic
    - fluid is cyled out overnight
28
Q

adv. for transplant

A
  • better QOL
  • ## longer lifespan