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Nephrology > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

At what CKD stage does EPO synthesis begin to decrease?

A

CKD3b

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2
Q

What cells synthesize EPO?

A

Interstitial fibroblasts

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3
Q

What is the goal Hb in patients with CKD/ESRD?

A

10-11.5 mg/dl

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4
Q

At what transferrin saturation and ferritin level should you start PO/IV iron?

A

Tsat < 30% and ferritin < 500

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5
Q

What 5 factors can make EPO less effective?

A

1) Iron deficiency
2) Inflammation/Infection
3) High PTH
4) Inadequate HD
5) Red cell aplasia (antibody mediated reaction to ESA)

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6
Q

Name two examples of calcimimetic drugs?

A

1) Cinacalcet
2) Etelcalcetide

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7
Q

How to calcimimetic drugs work?

A

Bind calcium sensing receptor in parathyroid gland decreasing PTH release

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8
Q

What is the effect of 1,25 OH vitamin D on PTH?

A

Acts on transcriptional level to decrease PTH synthesis

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9
Q

What is the effect of hyperphosphatemia on PTH?

A

Phosphorus decreases mRNA degradation of PTH resulting in increased PTH levels

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10
Q

What is the effect of FGF23 and PTH on serum phosphorus?

A

FGF23: decrease (renal wasting)
PTH: decrease (renal wasting)

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11
Q

What is the effect of FGF23 and PTH on 1,25 OH vitamin D?

A

FGF23: decrease
PTH: increase

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12
Q

How is a SGLT2i renoprotective?

A

Blocking of the sodium glucose cotransporter causes more distal sodium delivery to the JGA causing decreased release of renin and RAAS suppression leading to decreased intraglomerular pressure

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13
Q

Deficiency in what cation can result in hyperammonemia?

A

Zinc

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14
Q

How do you diagnose ADPKD on imaging?

A

10 or more cysts bilaterally

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15
Q

What is the drug of choice for infected renal cyst?

A

Ciprofloxacin

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16
Q

When should you start a statin in a patient with CKD?

A

Age 50 or greater + CKD3

17
Q

At what CKD stage should metformin be stopped?

A

CKD4

18
Q

What is the optimal pneumococcal vaccination schedule for ESRD patients?

A

PCV13 —> PPSV23 (8 weeks later) —> PPSV23 (5 years later)

19
Q

What is the treatment of lupus nephritis with minimal proteinuria?

A

ACEi/ARB + HCQ

Nephrology (10 decks)

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