CKD

Question 1

CKD recognition

Answer 1

early detection and proper treatment slow the disease progression

• hard to diagnose based on presenting symptoms
• saves money!!

Question 2

Screening for CKD

Answer 2

High risk groups!

- DM, CVD, HTN, hyperlipidemia, obesity, smoking, HIV, hepatitis

Question 3

CKD definition

Answer 3

kidney damage OR GFR<60 ml/min for greater than 3 months

kidney damage = pathological abnormality in blood or urine or imaging

Question 4

Stages of CKD

Answer 4

1 - kidney damage and GFR>90
2 - kidney damage and GFR 60-90
3 - kidney damage and GFR 30-80
4 - severe GFR 15-30
5 - kidney failure GFR <15

Question 5

Variables that affect GFR

Answer 5

Age, Weight, and serum creatinine

Question 6

Management of CKD

Answer 6

1 - Treat reversible causes of renal dysfunction
2 - Prevent or slow progression of renal disease
3 - Treat complications of renal dysfunction
4 - Prepare and initiate renal replacement therapy

Question 7

Reversible Causes of Renal Dysfunction

Answer 7

Pre-renal (dehydration, hypotension)
Renal (nephrotoxic –> NSAIDs)
Post-renal (obstruction –> prostate)

Question 8

Slowing Rate of Progression

Answer 8

ACE inhibitors, ARBs
treat HTN
Protein restriction
treat hyperlipidemia
glycemic control (A1C)

Question 9

Treat complications of renal dysfunction

Answer 9

Volume overload
Hyperkalemia
Metabolic acidosis (bicarb)
Hyperphosphatemia (dairy restriction)
Hyperparathyroidism (active Vit D)
Anemia