chronic kidney disease and ESKD Flashcards

1
Q

what is chronic kidney disease

A

presence of kidney damage for more than 3 months with or without a GFR (glomerular filtration rate) of <60

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2
Q

in chronic kidney disease there is an inability to

A

maintain acid-base balance, remove end products of metabolism, maintain fluid and electrolyte balance

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3
Q

causes of CKD

A

hypertension, diabetes, glomerulonephritis

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4
Q

risk factors of CKD

A

family history, increase age > 60, male, african american, HTN, DM, smoking, overweight/obesity

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5
Q

patho of CKD

A

glomerulosclerosis (scar tissues of glomerus) –> cannot properly filter blood –> interstitial fibrosis –> interstitial inflammation

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6
Q

what plays a role in CKD

A

complement (part of inflammatory process causes destruction of kidney tissues) angiotensin 2 –> increases BP –> more damage

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7
Q

how to treat CKD

A

reduce BP, treat hyperlipidemia, volume overload, hypekalemia, metabolic acidosis, hyperphosphatemia, renal osteodystrophy, anemia

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8
Q

stages of CKD

A

1: kidney damage w/ normal or increased GFR >/= 90
2: kidney damage w/mild decrease in GFR 60-89
3: moderate decrease in GFR 30-59
4: severe decrease in GFR 15-29
5: end stage kidney disease GFR <15

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9
Q

treatment for hyperphosphatemia

A

calcium carbonate (Tums)
MOA: binds to phosphate
Goal: keep phosphate levels normal
take with meals

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10
Q

treatment for metabolic acidosis

A

sodium bicarbonate
for slow progression, to prevent bone loss, improve nutritional status
initiate when HCO3 is <15
titrate to HCO3 of 18-20 –> if there is bloating switch to sodium citrate

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11
Q

treatment for renal osteodystrophy

A

calcitriol
moa: activated form of Vit D, stimulates intestinal absorption of calcium/phosphate and bone mineralization
Adverse effects: hypercalcemia, hyperphosphatemia, s/s of calcium toxicity –> GI upset, bone pain, neuro effects, cardiac arrhythmia

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12
Q

what is uremia

A

retention of metabolic waste building up due to lack of kidney filtration –> measured in BUN/Cr, electrolytes, retaining water –> GFR

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13
Q

clinical manifestations of end stage kidney disease

A

no longer maintains fluid and electrolyte homeostasis –> edema, hyperkalemia, hyperphosphatemia, hypermag, metabolic acidosis
no longer rids body of waste –> anorexia, malnutrition, itching, CNS changes
decreased production of erythropoietin –> anemia and renal osteodystrophy

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