Chronic kidney disease II

Question 1

definition: azotemia

Answer 1

• presence of NITROGENOUS waste products in the blood

- elevated BUN and creatinine

Question 2

definition: uremia

Answer 2

• azotemia plus constellation of signs and symptoms that may accrue as a result of renal failure

Question 3

indications for dialysis are due to uremia or azotemia?

Answer 3

uremia - need constellation of symptoms

Question 4

what is the main complication of uremia?

Answer 4

CV

Question 5

what is the number one cause of death in CKD patients?

Answer 5

CVD

Question 6

definition: CKD-MBD

Answer 6

systemic disorder of mineral and bone metabolism due to CKD, manifested by either one or a combination of:

• abnormalities in calcium, phosphorous, PTH, vitamin D
• abnormalities in bone turnover, mineralization, volume linear growth, strength
• extra skeletal calcification

Question 7

what labs are usually seen in CKD patients?

Answer 7

• high phosphorous
• normal or low calcium
• secondary hyperPTH

Question 8

calciphylaxis

Answer 8

type of extraosseus calcification characterized by systemic medial calcification of the arterioles that leads to ischemia and subQ necrosis

Question 9

calciphylaxis: histology

Answer 9

• small vessel mural calcification with or without endovascular fibrosis
• extravascular calcification
• thrombotic vaso-occlusion

Question 10

slowing the rate of progression of CKD is about modifying what process?

Answer 10

maladaptive hyperfiltration

Question 11

what is the target BP in diabetics and non-diabetics with CKD and urine albumin UNDER 30 mg/24 hours?

Answer 11

less than or equal to 140 / 90

Question 12

what is the target BP in diabetics and non-diabetics with CKD and urine albumin OVER 30 mg/24 hours?

Answer 12

less than or equal to 130 / 90

Question 13

what is the recommended target HbA1c for glycemic control in prevention of CKD progression?

Answer 13

under 7%

Question 14

patients with GFR under 15 mL/min are prone to ______________

Answer 14

increased ECF

Question 15

what is the treatment for CKD volume overload?

Answer 15

• salt and water restriction

- diuretic therapy (loop)

Question 16

when is anemia diagnosed in patients with CKD?

Answer 16

• Hb under 13.0 g/dL males, 12.0 g/dL females

Question 17

what is the treatment for anemia in CKD patients?

Answer 17

EPO and nutritional supplements

Question 18

what is the goal Hb in CKD anemia?

Answer 18

10 - 11 g/dL

Question 19

what is the treatment for CKD hyperkalemia?

Answer 19

• low K diet

- diuretics and alkali

Question 20

when does hyperphosphatemia occur (early / late)? what does it lead to?

Answer 20

• occurs early

- leads to secondary hyperPTH

Question 21

what are the treatment options for CKD V?

Answer 21

• maintenance hemodialysis
• peritoneal dialysis
• kidney transplant
• palliative care

Question 22

which has better survival rates - dialysis or transplant?

Answer 22

transplant