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Ntrnl Bchmstry > CKD > Flashcards

CKD Flashcards

1
Q

How many L of fluid of ultrafiltrate is produced in filtering this blood and through active process of reabsorbing certain components and excreting others

A

180 L of fluid of ultrafiltrate

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2
Q

L of urine excreted in an average per day.

A

1.5 L of urine

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3
Q

The kidney can get rid of as little as ____ of concentrated urine or as much as ___.

A

500ml

12 L.

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4
Q

Urinary volume of <500 ml/day is called

A

oliguria.

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5
Q

Solute Load consists of

A

Nitrogenous wastes & Electrolytes

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6
Q

Nitrogenous wastes consists of

A

Urea
Uric acid
Creatinine
Ammonia

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7
Q

Electrolytes

A

Na
K
Cl

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8
Q

Renal Diseases that needs protein restriction

A

Glomerular disease
Acute Renal Failure
Chronic Kidney Disease

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9
Q

What are the 2 types of Glomerular Disease?

A 
Nephritic Syndrome (uremic)
Nephrotic Syndrome
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10
Q

What is Nephritic Syndrome?

A

The syndrome of hematuria, hypertension, and mild loss of renal function that results from acute inflammation of the capillary loops of the glomerulus.

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11
Q

Medical Nutrition Therapy for Nephritic Syndrome

A
  • Sodium restriction - HPN

- Restricting protein or potassium intake is of no benefit unless significant uremia or hyperkalemia develops

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12
Q

A condition resulting from loss of the glomerular barrier to protein, characterized by massive edema, proteinuria, hypoalbuminemia, hypercholesterolemia, hypercoagubility, and abnormal bone metabolism.

A

Nephrotic Syndrome

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13
Q

Medical Nutrition Therapy for Nephrotic Syndrome

A

0.8 gm/kg/day can decrease proteinuria without adversely affecting serum albumin.

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14
Q

% of HBV for protein optimal use for nephrotic syndrome

A

75% HBV

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15
Q

Kcal for adult and children for nephrotic syndrome

A

35 kcal/kg/day for adults

100-150 kcal/kg/day for children

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16
Q

Sodium allowance for nephrotic syndrome

A

Sodium – 3 gm/day

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17
Q

CKD structural criteria

A

Kidney damage for > 3 months

albuminuria is the most common marker of kidney damage and is associated with rapid progression

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18
Q

CKD Functional criteria

A

GFR < 60 mL/min per 1.73m2 for > 3 months

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19
Q

Normal GFR

A

125 mL/min

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20
Q

GFR (M)

A

weight (kg) x 140 – age/

72 x serum creatinine (mg/dl)

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21
Q

GFR (W)

A

weight (kg) x 140 – age X 0.85/

72 x serum creatinine (mg/dl)

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22
Q

Stage 1 Serum creatinine of AKI

A

1.5–1.9 times baseline or > 0.3 mg/dl (>26.5 mmol/l) increase

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23
Q

Stage 1 Urine output of AKI

A

<0.5ml/kg/h for 6-12 hours

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24
Q

Stage 2 Serum creatinine of AKI

A

2.0–2.9 times baseline

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25
Q

Stage 2 Urine output of AKI

A

<0.5 ml/kg/h for >12 hours

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26
Q

Stage 3 Serum creatinine of AKI

A

3.0 times baseline or
Increase in serum creatinine to
> 4.0 mg/dl (> 353.6 umol/l)
Initiation of renal replacement therapy

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27
Q

Stage 3 Urine output of AKI

A

<0.3ml/kg/h for > 24 hours or Anuria for > 12 hours

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28
Q

Treatment of AKI

A
  1. Replace renal function if warranted
  2. Create a space for all the fluids that will be given to the patient.
  3. Protein requirement
  4. Calorie requirement
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29
Q
  1. Replace renal function if warranted

Absolute Indications:

A

Intractable Hyperkalemia
Intractable Fluid Overload
Intractable Metabolic Acidosis
Uremic Manifestations

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30
Q

AKI Protein requirement

A

should not be less than 0.8 g/kg/day.

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31
Q

AKI Protein requirement if ptx is catabolic

A

1.2 g to 1.5 g protein (or amino acids)/kg/day in patients with AKI who are catabolic.

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32
Q

AKI Calorie requirement

A

20 to 30 kcal/kg/day;
even when they are in a hypermetabolic
state because of other underlying diseases
(i.e. sepsis or multiple organ failure),

should not exceed 30 kcal/kg/day in any patient with AKI.

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33
Q

Normal adult urine output

A

1 to 1.5L/day

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34
Q

Anuria

A

<100ml or urine output per day

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35
Q

Oliguria

A

100 to 400 ml of urine output per day

36
Q

Polyuria

A

> 3L of urine output per day

37
Q

It is characterized by the failure of kidney function to return to normal after acute kidney failure due to renal disease.

A

Chronic Renal Failure

38
Q

CRF may be caused by:

A

glomerulonephritis, chronic infections(pyelonephritis), genetic defects, chronic hypertension and others.

39
Q

is the most common treatment for kidney failure.

A

hemodialysis

40
Q

is an artificial kidney designed to remove impurities from your blood.

A

A dialysis machine

41
Q

CAPD

A

Continuous Ambulatory Peritoneal Dialysis

42
Q

is done at home, usually 4 times every day. It takes less than 30 minutes each time and is a very simple, painless procedure. Because dialysis is carried out at home patients must be able and willing to take the major responsibility for their own care.

A

CAPD

43
Q

MNT for hemodialysis

A

Less CHON is lost in HD than with peritoneal dialysis, nevertheless, amino acid losses still occur

44
Q

Sodium content of 1/8 tsp salt

A

250 mg Na

45
Q

Sodium content of ¼ tsp salt

A

500 mg Na

46
Q

Sodium content of ½ tsp

A

1 gm Na

47
Q

Sodium content of 1 tsp salt

A

2 gm Na

48
Q

Sodium content of 1 tbsp salt

A

6 gm Na

49
Q

an abnormality of kidney structure or function regardless of cause or specific clinical presentation and proposed a staging system based on the level of GFR.

A

CKD

50
Q

The kidney receives __ % of cardiac output which allows the filtering of approximately __ L/day

A

20%

1600 L/day of blood

51
Q

If the label says
Sodium free/salt free
it means

A

<5mg Na per serving

52
Q

If the label says
Very low sodium
it means

A

<35mg Na per serving

53
Q

If the label says
Low sodium
it means

A

<140 mg Na per serving

54
Q

If the label says
Reduced sodium
it means

A

At least 25% less Na than original product

55
Q

If the label says
Light in sodium
it means

A

At least 50% less Na than original product

56
Q

If the label says
Unsalted/no added salt
it means

A

No salt added during processing ( not salt-free)

57
Q

Types of HYDRATION STATUS

A

Oncotic pressure

Osmotic pressure

58
Q

the pressure at the capillary membrane due to dissolved proteins in the plasma & interstitial fluid

A

Oncotic pressure

59
Q

the pressure at the cell membrane of the body fluids

A

Osmotic pressure

60
Q

Dehydration – can result from:

A
  • decreased H20 intake
  • excessive H20 output
  • heavy solute load
61
Q

Edema – can result when there is:

A
  • a decrease in plasma proteins

- a decrease in plasma oncotic pressure secondary to malnutrition & other causes

62
Q

WHO CANNOT RECEIVE A TRANSPLANT:

A
  • persons over 50 with poor health
  • history of CA
  • children below 20 kg BW
63
Q

WHO CANNOT DONATE:

A
  • siblings under 18 y/o
64
Q

commonly associated with cyclosporine therapy warrants dietary K restriction, although this is only temporary.

A

Hyperkalemia

65
Q

FRUITS HIGH IN K:

1 med papaya

A

781 mg

66
Q

FRUITS HIGH IN K:

½ pureed avocado

A

729 mg

67
Q

FRUITS HIGH IN K:

1 slice watermelon

A

559 mg

68
Q

FRUITS HIGH IN K:

1 slice honeydew

A

461 mg

69
Q

FRUITS HIGH IN K:

1 medium banana

A

451 mg

70
Q

are experienced by renal transplant patients caused by bone resorption associated with persistent hyperparathyroidism & effects of steroids on Ca, P & vitamin D metabolism.

A

Hypophosphatemia & mild hypercalcemia

71
Q

FOODS RICH IN CALCIUM:

A

Milk Cheese
Broccoli Soy milk
Tofu Sesame seed
Kale Yogurt

72
Q

Majority of transplant recipients have elevated ____, ____, or _____.

A

serum triglycerides or cholesterol.

73
Q

Intervention for transplant recipients consists of ____ ____ if overweight, cholesterol intake limited to _______ and ____ ____ ____.

A

calorie restriction
200mg/day
Limited total fat

74
Q

The most common disorders that affect the kidneys and urinary tract. Develop when stones constituents become concentrated in the urine and form crystals that grow.

A

KIDNEY STONES

75
Q

Kidney stones is characterized by frequent occurrences between the ages ___ to ___ predominance in ____ (3X more often).

A

30 to 50,

males

76
Q

are frequently associated with gout, Uric acid stones form when urine is supersaturated with undissolved uric acid, which occurs at urinary pH less than 5.5. Alkalinize urine with citrate or bicarbonate

A

Uric acid stones

77
Q

Dietary Management for kidney stones

A

Diets restricted in Purine is prescribed to prevent uric acid stones

The body synthesized cystine, NEAA from methionine;therefore patient with Cystine stones needs just enough methionine from the diet, and reduction of urine acidity is beneficial.

78
Q

FOODS HIGH IN URIC ACID

A 
Organ Meats
Anchovies
Sardines
Meat-based broth
Gravy
79
Q

plays an important role in calcium stone formation.

A

Hyperoxaluria

80
Q

The normal oxalate content is in the range of ___ to ___ mg/day & absorption does not usually exceed __% to __% of the amount in food.

A

80 to 100 mg/day

10% to 20%

81
Q

Oxalate cannot be metabolized in the body.

True or false.

A

True

82
Q

renal route is the only mode of excretion of oxalate.

True or false.

A

True

83
Q

FOODS HIGH IN OXALATE

A 
Spinach 600-970 mg oxalate/100g 
Soy burger patty 870 mg oxalate/100g 
Almond 383 mg oxalate/100g 
Tofu 140-280 mg oxalate/100g 
Pecans 202 mg oxalate/100g 
Peanuts 187 mg oxalate/100g 
Okra 146 mg oxalate/100g 
Chocolate 117 mg oxalate/100g 
Sweet Potato  56 mg oxalate/100g
84
Q

FOODS LOW IN OXALATE

A 
Animal foods
Avocado
Cantaloupe
Cauliflower
Cucumber
Lemon juice
Melon
Radish
Squash
85
Q

Dietary intake can influence the acidity or alkalinity of the urine. The acid-forming potential contributed by chloride, phosphorus & sulfur (anions) and the base-forming potential by sodium, potassium, calcium and magnesium (cations)

True or false.

A

True

Ntrnl Bchmstry (31 decks)

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