Chronic Kidney Disease/Transplant

Question 1

Top 3 diseases associated with CKD?

Answer 1

Diabetes, HTN, and GN

Question 2

What is the GFR for stage 1 CKD?

Answer 2

Greater than 90

Question 3

Stage 2 GFR?

Answer 3

60-89

Question 4

Stage 3a GFR?

Answer 4

45-59

Question 5

Stage 3b GFR?

Answer 5

30-44

Question 6

Stage 4 GFR?

Answer 6

15-29

Question 7

Stage 5 GFR?

Answer 7

Less than 15

Question 8

What is A1 albinuria, A2 and A3?

Answer 8

Less than 30, 30-300, and over 300

Question 9

What health condition do we find in stage 2 CKD?

Answer 9

HTN

Question 10

What two conditions do we find in stage 3 CKD?

Answer 10

Increase in parathyroid hormone and anemia

Question 11

What two conditions do we find in stage 4 CKD?

Answer 11

Acidosis and hyperkalemia and hyper phosphate

Question 12

Stage 5 CKD condition?

Answer 12

Uremia

Question 13

What’s going on with CKD and sodium?

Answer 13

Excretion goes down, so we have way too much retained, volume goes up and leads to hypertension

Question 14

What’s goin on with Potassium and CKD?

Answer 14

Unaffected unless there is some exogenous action affecting it.

Question 15

What is the type of acidosis with CKD that initially presents and at what level, and then what does it turn into at what level of GFR?

Answer 15

At GFR of 40 we have a hyperchloremic acidosis (normal). And then at about 15-20 it turns into an anion gap because the kidney isn’t getting rid of acids.

Question 16

3 things going on with bone metabolism because of CKD and what is the 1 result?

Answer 16

Hyper phosphate, hypocalcium, hypo vitamin d. All three leading to hyperparathyroidism

Question 17

2 clinical symptoms of hyperparathyroidism?

Answer 17

Muscle weakness and just sick

Question 18

How is the heart affected by CKD?

Answer 18

Too much parathyroid hormone causes cardiac muscle fibrosis

Question 19

What is the number one cause of mortality in patients with CKD?

Answer 19

CV disease

Question 20

What is causing patients with CKD to be anemic? What type of anemia is it?

Answer 20

Decreased erythropoietin production. Normochromic, normocytic anemia

Question 21

When do we start to see neuromuscular irritability in CKD, what stage?

Answer 21

3

Question 22

What CKD stage do we see peripheral neuropathy?

Answer 22

Stage 4. Sensory before motor.

Question 23

What is the GI effect she talked about because of CKD?

Answer 23

Breath smelling like urine

Question 24

What 1 hormone is increased with CKD and two hormones decreased?

Answer 24

Insulin in increased and estrogen and testosterone is decreased in women and men.

Question 25

What two things are going on with the skin because of CKD?

Answer 25

Hyperpigmentation and itching (because of high phosphate).

Question 26

What is the target BP for these CKD patients and what two meds are first line?

Answer 26

130/80. ACE and ARBS

Question 27

3 drug families to avoid in patients with CKD?

Answer 27

NSAIDS, antibiotics, and anti arrhythmias

Question 28

What GFR do we refer to nephrology?

Answer 28

Less than 30

Question 29

What GFR do we do dialysis or transplant?

Answer 29

Less than 15