CKD

Question 1

What is the prevalence of CKD?

Answer 1

10% US

Question 2

Is screening effective for CKD?

Answer 2

No

Question 3

What are come risk factors for CKD?

Answer 3

DM
CVD
HTN
Hyperlipids
Obesity
Metabolic syndrome
Smoking
HIV
Hepatitis C
Malignancy

Question 4

What are some other risk factors for CKD?

Answer 4

• Family HX
• > 60 year old
• Treatment with nephrotoxic drugs

Question 5

What is the definition of CKD?

Answer 5

Kidney damage or GFR <60 for greater than 3 months

Question 6

What are the top 3 contributors to CKD?

Answer 6

DM2
HTN
Glomerulonephritis

Question 7

What is the 1st stage of CKD?

Answer 7

Kidney damage with GFR >90

Question 8

What is 2nd stage of CKD?

Answer 8

Kidney damage with GFR of 60-89

Question 9

What is the 3rd stage of CKD?

Answer 9

Moderately decreased GFR at 30-59

Question 10

What is the 4th stage of CKD?

Answer 10

Severely decreased GFR at 15-29

Question 11

What is the 5th stage of CKD?

Answer 11

Kidney failure at GFR <15

Question 12

What is the definition of kidney damage?

Answer 12

Pathological abnormality in blood or urine tests or imaging

- UA, Urine alb, pro/Cr and serum creatinine

Question 13

What is the best measurement of GFR?

Answer 13

CKD-Epi formula

Question 14

What is plasma creatinine good for?

Answer 14

Simple

Question 15

What are the limitations of creatinine?

Answer 15

Inaccurate with mild renal impairment

• reduced in low muscle
• increase with high protein diet
• affected by certain drugs

Question 16

What is Cystatin C?

Answer 16

• Low molecular wt produced by all nucleated cells
• Not affected by diet, gender, age, muscle mass
• affected by steroids

Question 17

What is creatinine clearance good for?

Answer 17

Urine collections unreliable

• overestimates GFR
• Drug influences creatinine assays

Question 18

What is the Cockroft-Gault formula?

Answer 18

140-agewt/72Scr

• avoids urine collection
• Overestimates for obesity and low protein diet
• better than plasma creatinine for renal impairment

Question 19

What is MDRD?

Answer 19

Modification of Diet in Renal Dz

- 186Scrage0.742 (Females) 1.210

Question 20

What is CDK-EPI?

Answer 20

included age, sex, race and serum creatinine

- 60mL/min/1.73m^2

Question 21

What is the best approximation of true GRF?

Answer 21

Plasma clearance

• invasive
• use radioisotopes

Question 22

What is the management of CKD?

Answer 22

1. Treatment of reversible causes of renal dysfunction
2. Preventing or slowing progression of renal dz
3. Treatment of complication of renal dysfunction
4. Preparation and initiation of renal replacement therapy