Chronic Kidney Disease/Transplant Flashcards
Top 3 diseases associated with CKD?
Diabetes, HTN, and GN
What is the GFR for stage 1 CKD?
Greater than 90
Stage 2 GFR?
60-89
Stage 3a GFR?
45-59
Stage 3b GFR?
30-44
Stage 4 GFR?
15-29
Stage 5 GFR?
Less than 15
What is A1 albinuria, A2 and A3?
Less than 30, 30-300, and over 300
What health condition do we find in stage 2 CKD?
HTN
What two conditions do we find in stage 3 CKD?
Increase in parathyroid hormone and anemia
What two conditions do we find in stage 4 CKD?
Acidosis and hyperkalemia and hyper phosphate
Stage 5 CKD condition?
Uremia
What’s going on with CKD and sodium?
Excretion goes down, so we have way too much retained, volume goes up and leads to hypertension
What’s goin on with Potassium and CKD?
Unaffected unless there is some exogenous action affecting it.
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?
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.
3 things going on with bone metabolism because of CKD and what is the 1 result?
Hyper phosphate, hypocalcium, hypo vitamin d. All three leading to hyperparathyroidism
2 clinical symptoms of hyperparathyroidism?
Muscle weakness and just sick
How is the heart affected by CKD?
Too much parathyroid hormone causes cardiac muscle fibrosis
What is the number one cause of mortality in patients with CKD?
CV disease
What is causing patients with CKD to be anemic? What type of anemia is it?
Decreased erythropoietin production. Normochromic, normocytic anemia
When do we start to see neuromuscular irritability in CKD, what stage?
3
What CKD stage do we see peripheral neuropathy?
Stage 4. Sensory before motor.
What is the GI effect she talked about because of CKD?
Breath smelling like urine
What 1 hormone is increased with CKD and two hormones decreased?
Insulin in increased and estrogen and testosterone is decreased in women and men.
What two things are going on with the skin because of CKD?
Hyperpigmentation and itching (because of high phosphate).
What is the target BP for these CKD patients and what two meds are first line?
130/80. ACE and ARBS
3 drug families to avoid in patients with CKD?
NSAIDS, antibiotics, and anti arrhythmias
What GFR do we refer to nephrology?
Less than 30
What GFR do we do dialysis or transplant?
Less than 15
