CKD

Question 1

What makes someone high risk for CKD?

Answer 1

DM, CVD, HTN, high cholesterol, obesity, smoking

Family HX, > 60 yoa, nephrotoxic drugs

Question 2

What is the number one cause for CKD?

Answer 2

Type II Diabetes, HTN #2

Question 3

Name disadvantages of testing plasma creatinine to estimate GFR

Answer 3

inaccurate with mild impairment
low w/low muscle mass
high w/high protein meal
affected by drugs

Question 4

What is the most accurate equation for Estimated GFR?

Answer 4

CKD -Epei which has replaced MDRD which is more accruate than Cockrott Gault

Question 5

What is the advantage of measuring Cystatin C instead of cret.?

Answer 5

NOt affected by diet, gender, age, muscle mass

Question 6

What are disadvantages of measuring plasma clearence of Isotopes/non-isotopes?

Answer 6

Invasive and uses radioisotopes

Overall is best approximation.

Question 7

4 ways to manage CKD?

Answer 7

Treat reversible causes
prevent/slow progression
treat complications
RRT

Question 8

What are the 3 reversible causes of CKD?

Answer 8

decreased renal perfusion
nephrotoxic drugs
urinary tract obstruction

Question 9

name some ways to slow progression of CKD

Answer 9

ACE/ARBS
HTN tx
restrict protein
treat hyperlipidemia
control HbA1c
Avoid bad drugs
stop smoking
don't be fat

Question 10

What are some complications of CKD?

Answer 10

volume overload
high K+
high Phospate
Secondary hyperparathyroidism
anemia
metabolic acidosis

Question 11

How do you treat hyperparathryoidism?

Answer 11

First correct high phospate then treat with Calcitrol

Question 12

What are some risks of treating metabolic acidosis with bicard supplements?

Answer 12

can worsen bone disease adn decrease muscle mass

Question 13

How is anemia secondary to CKD treated?

Answer 13

EPO or Darbepoetin