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Renal- PA Sp23 > CKD > Flashcards

CKD Flashcards

1
Q

Kidney damage with ____ or ___ GFR is Stage __ CKD.

GFR= > ____
Increased GFR–> proteinuria, renal hematuria, cystic disease, etc.

A

normal, increased, 1, 90

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2
Q

____ decrease in GFR is Stage __ CKD.

GFR= ___- 89

A

Mild, 2, 60

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3
Q

____ decrease in GFR is stage __ CKD.

GFR= __- 59

A

Moderate, 3, 30

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4
Q

___ decrease in GFR is stage __ CKD.

GFR= __- 29

A

Severe, 4, 15

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5
Q

Kidney failure is stage __ CKD.

GFR= < ___
This patient will most likely need dialysis.

A

5, 15

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6
Q

What are the 2 most common causes of CKD?

A

DM- 44%
HTN- 28%

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7
Q

What can a patient do to prevent progression of CKD? (6)

A
  1. control BP
  2. detect and treat microalbuminuria/ proteinuria
  3. treat metabolic acidosis
  4. control blood sugar
  5. treat reversible causes
  6. refer to nephro
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8
Q

What can used to treat microalbuminuria/ proteinuria?

A

ACEi, ARBs, SGLT2, GLP1R agonists, finerenone, protein restriction

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9
Q

What is adapative hyperfiltration?

A

When nephrons lost/ is not working right, the other nephrons must take over and work harder to keep up.

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10
Q

Name some complications of uremia.

A

fluid excess/ HTN, hyperkalemia, metabolic acidosis, hyperphosphatemia, anemia, malnutrition

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11
Q

what is the most common cause of fluid excess?

A

glomerular disease i.e Na retention

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12
Q

What is the treatment for fluid excess?

A

salt restriction!!!!!!!!
loop diuretics (unless GFR <30)
monitor weight!!
fluid restriction for hypoNa

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13
Q

When should you practice caution when treating edema?

A

if the patient has edema s/t nephrotic syndrome and is normotensive

excessive restriction can worsen condition

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14
Q

What is the most important factor in progression to ESRD?

A

HTN (both cause and effect of CKD)

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15
Q

Hypertensive pts with CKD are usually have ____ issues about ___% of the time. ____ restriction is essential as ____ restriction is not beneficial.

A

volume, 80, Na, fluid

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16
Q

What are the drugs of choice for hypertensive patients with CKD?

A

diuretics (loop or metolazone GFR <30)
ACEi or ARBs (unless GFR <30)
other HTN meds

17
Q

Hypertension in a CKD patient should ___ be treated.

A

ALWAYS

18
Q

BP goals for…
CKD w/ albuminuria or proteinuria

A

<130/80

19
Q

Bp goals for…
hx of CHF or EF <45%

A

<120/80

20
Q

BP goals for…
CKD alone

A

<140/90

21
Q

What is the preferred diastolic reading for patients with CAD + CKD?

A

> 70 so to perfuse the coronary arteries appropriately

22
Q

Blocking the ____ prevents progression of diabetic renal and glomerular disease

A

RAAS

23
Q

___ do not prevent the progression of diabetic renal disease.

A

CCBs

24
Q

Inhibition of Ang II…

A

relaxes afferent arterioles more than efferent arterioles which decreases intraglomerular pressure and diminishes adaptive hyperfiltration

25
Q

What is the cycle of NO life?

A
26
Q

The ____ is the primary organ of potassium excretion.

A

Kidney

27
Q

Name aggravating factors of hyperkalemia.

A

acidosis, Type IV RTA, volume depletion, ACEi/ARBs (+ K binder), K sparing, K supplements

28
Q

Treatment (outpatient) of hyperkalemia include:

A

dietary restriction, correction of acidosis, d/c supps or drugs, Kayexalate, Veltassa, Lokelma, RRT

29
Q

What is the goal bicarb?

A

23-28 mM/L

30
Q

Metabolic Acidosis usually has ___ ____ which is calculated by taking Na- (Cl+ HCO3)

A

Anion Gap

31
Q

What is an aggravating factor of metabolic acidosis?

A

RTA

32
Q

Treatment of metabolic acidosis includes:

A

arm and hammer baking soda (1/2 to 1 tsp/ day)
NaHCO3 tabs- 650 mg TID

33
Q

What can cause renal osteodystrophy?

A

hyperphosphatemia

34
Q

In hyperphosphatemia, the GFR < ___ cc/min

A

30

35
Q

When does extraosseous calcification occur?

A

Ca x Phos > 55

can cause pruritis; Ca builds up outside of bone

36
Q

Treatment for hyperphosphatemia includes:

A

dietary restrictions of phosphorus (d/c milk, cheese)
Phosphate binders (e.g. TUMS, calcium acetate, etc.)- decrease PO4 and K

37
Q

What are the causes of anemia in CKD?

A

DIMINISHED EPO
deceased life of RBCs
Uremic effect on marrow
blood loss
iron and/or folate def

38
Q

Treatment of anemia of CKD includes:

A

iron supps if needed
IV or SQ synthetic EPO (ESAs)
folic acid, B12 if indicated
packed RBCs

39
Q

What are the most common (5) reversible factors for renal function deterioration?

A
  1. volume depletion
  2. volume excess and CHF
  3. infection
  4. UTI
  5. Nephrotoxic agents

Renal- PA Sp23 (4 decks)

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