CKD Shepler Flashcards
3 major causes of CKD
-diabetes mellitus
-hypertension
-glomerulonephritis
GFR greater than or equal to 90 is what category of CKD?
G1 (normal or high)
GFR between 60-89 is what category of CKD?
G2 (mildly decreased)
GFR between 45-59 is what category of CKD?
G3a (mildly to moderately decreased)
GFR between 30-44 is what category of CKD?
G3b (moderately to severely decreased)
GFR between 15-29 is considered what category of CKD?
G4 (severely decreased)
GFR less than 15 is considered what category of CKD?
G5 (kidney failure)
what formula is used most commonly for estimation of creatinine clearance?
Cockcroft-Gault equation
Men: (140-age)IBW/(SCr * 72)
Women: CrCl * 0.85
what is uremia?
build up of waste products in the blood (increase in BUN, pruritus, confusion, nausea, vomiting, anorexia)
normal BUN levels
15 or less
5 complications for kidney injury (from table; page 7)
-uremia
-fluid retention
-electrolyte imbalances
-mineral and bone disorder
-anemia
fluid restriction is not generally necessary if _____ intake is controlled
sodium
true or false: diuretics work in patients without functioning kidneys
false
thiazides are ineffective when CrCl < ___ mL/min
30
loop diuretics will work when CrCl < ___ mL/min
30
what is the bioavailability of furosemide, bumetanide, and torsemide?
furosemide 10-100
bumetanide 80-100
torsemide 80-100
(since furosemide is lower, we would give higher dose of this compared to the other 2)
as renal function declines, and the loop diuretic dose is maximized, a _____ may be added to the regimen to overcome diuretic resistance
thiazide
for electrolyte imbalances, how much sodium per day should a patient get?
< 2 g of sodium/day or < 5 g NaCl per day
for electrolyte imbalances, how much potassium should patients be restricted to?
3 gm/day (goal for ESRD patient is a pre-dialysis K conc of 4.5-5.5 mEq/L)
which of the following diuretics is least likely to cause an allergic sulfa reaction?
a. furosemide
b. ethacrynic acid
c. torsemide
d. bumetanide
b. ethacrynic acid
what organ activates vitamin D?
kidneys
normal phos levels range
2.5-4.5 mg/dL
true or false: phosphate binders must be taken with meals
true
two calcium containing phosphate binders
calcium carbonate (Tums)
calcium acetate (PhosLo)
calcium carbonate is what percent elemental calcium?
40%
calcium acetate is what percent elemental calcium?
25%
how much elemental calcium is in PhosLo?
169 mg
most common non-calcium containing phosphate binder?
sevelamer carbonate (Renvela)
if phos is 5.5-7.5, take _____ mg sevelemar tid; if phos is 7.5 or more, take _____ mg sevelemar tid
800; 1600
sevelamer increases/decreases uric acid levels
decreases
lanthanum carbonate (Fosrenol) is more efficacious at high or low pH?
low pH
lanthanum carbonate is elim in feces, has no long term accumulation, and does not cross _____
BBB (blood brain barrier)