CKD part 1 Flashcards
The higher the pt’s GFR is and the lower their albuminuria is the less in terms of complications or at risk this patient would be
As a pt’s GFR decreases and as their albuminuria increases this is going to put pt at higher risk of developing complications
What are symptoms people will experience in end stage kidney disease?
low urine output, increased side effects from medications, EDEMA, shortness of breath, changes in cognitive status, elevated serum creatinine, changes in hemoglobin levels, fatigued,weakness, trouble emulating tough for pts to walk
What medications need to reach a certain therapeutic concentration in order to be effective? antibiotics, seizure medications, narrow therapuetic drugs like warfarin and phenytoin
Extend interval or reduce dose of the medication and then there’s combination method which is both reducing the dose and extending the interval
When you think of someone’s decline of renal function is it a linear function or what?
Someone’s GFR can start off decent then it will drop then it will get stable and it will drop again and then it might go up again then drop
linear process like overall its going down
you have to establish a new base line for the pt over time but there’s a downward trend its back and forth over time its not like a straight line in a graph
CKD Management goals
Delay the progression of CKD
Minimize development or severity of associated complications
Treat people with CKD w/ a comprehensive treatment strategy to reduce risks of progression of CKD and its associated complications so focus on whats impacting CKD pathophysiology and modification of the natural course of CKD and its symptoms
Clinical Presentation
Asymptomatic
Depends on the severity of disease and more likely to be observed in stage 4 or stage 5 CKD
Patients with diabetes, hypertension, gastrointestinal abnormalities or autoimmune disease. Older adults, family history of kidney disease (we need to monitor these pts more closely)
Pharmacists need to prevent clinical symptoms and signs like elevated blood pressure, elevated blood sugars and elevated lipids so we need to manage those
Assess renal function regularly
Look at hemoglobin levels, vitamin D levels, potassium levels, phosphorous levels, calcium levels
Minimize risk of progression
manage risk and and appropriate treatment of complications such as cardiovascular disease, ____________, infections
hospitalizations
Lifestyle consdierations
Non-pharmacological treatment options: Stay well hydrated, lose weight, avoid ________and_________
Dietary considerations
avoid alcohol and avoid SMOKING
or to a level comptabile w/cardiovascular and physical tolerance means what?
if pt came in and had a stroke or pt is wheelchair bound so pts won’t be
tell them to do modified exercises with machines
What are some ways pts can lose weight nowadays? GLP-1s like ozempic, wegovy
Non-pharmacological Treatment
Exercise for at least 30 minutes 5x/week (________moderate intensity exercise weekly)
or to a level compatible with cardiovascular and physical
tolerance
No more than ______ alcoholic drinks for men/day, no more than 1
alcoholic drink/day for women
Smoking cessation
Lose weight if BMI >30 kg/m2
150 minutes moderate intensity exercise weekly
no more 2 alcoholic drinks for men
