CKD Flashcards
pts with CKD, regarding their diagnostic, make sure that
he is aware of his dx
investigations and treatments that can precipitate renal failure
metformin
contrast dye
bowel preparation
quand on prescrit des rx chez pt avec IRC il faut s’assurer de (3)
1) Sécurité des Rx : interactions (eg ne pas prescrire ACEi avec ARB) métabolisme
2) ajuster doses
3) Monitor the impact of the drug on the renal function more frequently
dans quel cas ajuster does (6)
ACE inhibitors, ARA
metformin
allopurinol
antibiotics
low molecular weight heparin, direct oral anticoagulants
Situations in which to pay attention to hydration when with renal failure (3)
when travelling
elderly patients in hot weather
when ill
what OTC to avoid when in renal failure (3)
NSAIDS
herbals
supplements
advise to give to pt when sick (2)
- Stop certain medications promptly (e.g., ACE inhibitors, diuretics, metformin, iSGLT2)
- Seek prompt reassessment
when AKI on CKD is resolved …
do not forget to start medication back LOL
CKD when to consult a specialist (4 ex in objective)
progressive renal failure
bone disease
refractory anemia
mild renal failure in a young person
CKD definition
Decreased kidney function (eGFR<60)
or kidney damage (urinary albumin) for 3 or more months
ACR ≥ 3 mg/mmol,
Who should be tested for CKD (5)
Hypertension
Diabetes
Age 60-75 with Cardiovascular disease
Age 18+ First Nations, Inuit, Metis
Other: Hereditary kidney disease, vasculitis, auto-immune (SLE)
reversible causes of AKI (4)
NSAIDs
contrast
BPH
urinary retention
how to screen for CKD
eGFR and urine ACR (Albumin-to-Creatinine ratio)
if you screened once for ckd and If eGFR <60, what to do next and ACR ≥ 3 mg/mmol,
repeat test in 3 months
Extended work up (4)
- Extended lytes: Ca, PO4, Acide urique et Mg (1x min)
- urine analysis
- RAC urinaire
- écho rénale
Complications des rx si pas ajustés (9)
Anticoagulants: hémorragie
o Allopurinol: DRESS, SJS
o Metformin: acidose lactique
o Opioïdes: toxicité SNC (dont arrêt respiratoire)
o Gabapentinoïdes: toxicité SNC
o Gadolinium: fibrose systémique néphrogénique
o Antihypertenseurs: hypotensions, bradycardie, hyperkaliémie
o Sulfolynurées, : hypoglycémies
o Colchicine: myotoxicité
