chronic kidney disease

Question 1

3 ways to help diff. AKI from CKD

Answer 1

1. Hx/Px
2. labs
3. investigations

Question 2

parts of Hx/Px

Answer 2

• ROS
• chronic diseases
• Pmhx
• new meds
• family Hx

Question 3

what does previos Cr tell you

Answer 3

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

Question 4

2 alternatives to Cr

Answer 4

1. eGFR

2. 24 hour urine

Question 5

2 investigations that might be helpful

Answer 5

1. US
   - small and shrunken in CKD
2. urinalysis

Question 6

def. of CKD (3)

Answer 6

1. kidney damage or eGFR

Question 7

how many stages of CKD

Answer 7

5

Question 8

2 main classification of kidney disease

Answer 8

diabetic vs. non-diabetic

Question 9

3 most common causes of CKD

Answer 9

1. diabetes
2. vascular disease
3. glomerular disesase

Question 10

what is new focus in CKD

Answer 10

1. early diagnosis and intervention

2. focus on CKD like a CHD risk level

Question 11

what is survivia;

Answer 11

• most die of heart disease

- poor surival

Question 12

what is step 1

Answer 12

think about a ACEi or ARB

Question 13

what is step 2

Answer 13

tight blood pressure control

Question 14

step 3

Answer 14

use a statin to target LDL

Question 15

step 4

Answer 15

smoking cessation

Question 16

step 5

Answer 16

optimize glycemic control

Question 17

step 6

Answer 17

patients with eGFR

Question 18

2 times when need to refer to a nephro

Answer 18

1. rapid deterioration in kidney function as defined by eGFR

2. or eGFR

Question 19

what is relationship between CKD and anemia

Answer 19

low GFR>low EPO> anemia

Question 20

what is relationship between CKD and bone metabolism

Answer 20

Due to secondary hyperparathyoidism

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

Question 21

4 indication for dialysis

Answer 21

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

Question 22

4 indication for dialysis

Answer 22

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

Question 23

2 goals of dialysis

Answer 23

1. solute/toxin removal (purification)

2. salt and water removal (ultrafiltration)

Question 24

difference between 2 dyalisysis choices

Answer 24

none- patient pref

Question 25

what is hemodyalisis

Answer 25

required IV access with a tunneled catheter

Question 26

what is peritoneal dyalisis

Answer 26

fluid exchanced through the perioneum

Question 27

2 types of pertioneal

Answer 27

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

Question 28

adv. for transplant

Answer 28

• better QOL
• ## longer lifespan