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CPR II Exam 3 > CKD (Selby) > Flashcards

CKD (Selby) Flashcards

1
Q

<3mo with <60 GFR

A

is AKI

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2
Q

CKD definition

A

either a marker of kidney damage (one of more) or decreased GFR for >3 months

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3
Q

markers of kidney damage

A

albuminuria

urine sediment abnormalities

electrolyte/other abnormalities due to tubular disorder

abnormalities detected by histology

structural abnormalities detected by imaging

Hx of transplant

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4
Q

CKD as defined by GFR

A

<60 mL/min for >3 months

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5
Q

CKD stage 1

A

> 90

normal or high

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6
Q

CKD stage 2

A

60-89

mild decrease

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7
Q

CKD stage 3a

A

45-59

mild to moderate decrease

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8
Q

CKD stage 3b

A

30-44

moderate to severe decrease

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9
Q

CKD stage 4

A

15-29

severe decrease

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10
Q

CKD stage 5

A

<15

kidney failure/ESRD

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11
Q

in absence of evidence of kidney damage stage 1 or 2

A

is NOT enough to fulfill criteria for CKD

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12
Q

what causes CKD the most

A

diabetes

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13
Q

what is the second most common cause of CKD

A

HTN

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14
Q

what is the third most common cause of CKD

A

glomerulonephritis

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15
Q

diabetes and HTN together make up what percent of CKD

A

64%

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16
Q

clinical presentation of CKD

A

is dependent on severity

many patients are asymptomatic and are found from routine testing

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17
Q

signs and symptoms of CKD

A 
Edema
HTN
oliguria
Foamy urine
Uremia
Pericardial friction rub
asterixis
Uremic frost
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18
Q

what is asterixis

A

tremor of the hand while arm is extended

19
Q

Serum creatinine

A

poor marker of kidney function

20
Q

eGFR

A

estimated GFR based on a few different formulas and is not accurate in setting of rapidly changing creatinine

21
Q

measured GFR

A

most accurate method but only performed in some institutions

22
Q

creatinine clearance

A

tends to overestimate GFR

23
Q

proteinuria

A

urine albumin to creatinine ration or urine protein to creatinine ratio

24
Q

diagnosis of CKD

A 
serum creatinine
GFR
Creatinine clearance 
Proteinuria 
Urinalysis with microscopy
Renal Biopsy
25
Q

diagnosis of CKD imagining

A

renal US
Doppler Renal US
abdominal CT scan
Abdominal MRI scan

26
Q

renal US findings for CKD

A

atrophic or small kidneys
cortical thinnings
increased echogenicity
elevated resistive indices

27
Q

3 simple tests to identify most CKD

A

eGFR
urine albumin to creatinine ratio
urinalysis

28
Q

RI ==

A

(peak systolic flow -lowest diastolic flow)/peak systolic flow

29
Q

RAR

A

PSVrenal/PSVaorta

30
Q

renal US

A

can evaluate size of kidney/cortical thickness/echogenicity/presence of hydronephrosis/renal mass/cysts

31
Q

doppler renal US

A

evaluate for renal artery stenosis (RAS) or renal vein thrombosis or resistive index

32
Q

abdominal CT scan

A

better at detecting masses and kidney stones

can evaluate for the same things as renal US

33
Q

abdominal MRI

A

can evaluate for renal artery stenosis
renal vein thrombosis
renal masses

34
Q

treatment of CKD complication: proteinuria

A

low Na diet
BP control
ACEi/ARB/aldosterone /renin inhibitor

35
Q

treatment of CKD complication: HTN goal pressure

A

if no proteinuria goal 140/90

if proteinuria goal 130/80

36
Q

treatment of CKD complication: hyperlipidemia

A

statins

37
Q

treatment of CKD complication: anemia

A

oral or IV iron

EPO stimulating agent (ISA)

38
Q

treatment of CKD complication: metabolic acidosis

A

HCO3 supplement if HCO3 < 22

39
Q

treatment of CKD complication: hyperkalemia

A

renal failure diet (low Na/K/Phos)

diuretics

sodium polystyrene sulfonate

40
Q

treatment of CKD complication: CKD-BMD

A 
secondary hyperPTH
renal failure diet
phosphorus binder 
Vit D supplement
Calcimimetics (lower PTH)
dialysis
41
Q

treatment of CKD complication: volume overload

A

diuretics

fluid restriction

dialysis

42
Q

dialysis indication

A 
AEIOU
Acidosis (severe)

Electrolyte disturbance (usually hyperkalemia)

Ingestion (ethylene glycol)

Overload (volume)

Uremia

43
Q

RRT (renal replacement therapy)

A

hemodialysis
peritoneal dialysis
renal transplant

CPR II Exam 3 (13 decks)

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