ckd1 Flashcards
what are the normal albumin to creatinine ratios?
less than 30 mg/g
what are the microalbuminaria albumin to creatinine ratios
30-300 mg/g
what are the albuminaria albumin to creatinine ratios
greater than 300 mg/g
a spot urine protein to creatinine ration greater than what indicates proteinuria
greater than 200 mg/g
what are the GFR levels fro stage 1 CKD
greater than 90 with evidence of kidney damage
what are the GFR levels fro stage 2 CKD
60-89 with evidence of kidney damage
what are the GFR levels fro stage 3 CKD
30-59
what are the GFR levels fro stage 4 CKD
15-29
what are the GFR levels fro stage 5 CKD
less than 15 or dialysis
why should Scr alone not assess kidney function
SCr has high variability
what equation should be used to stage kidney function in children
Schwartz equation
what equation should be used to stage kidney function in adults
MDRD equation
what does RRT refer to
dialysis
what are two most common initiation factors for CKD
diabetes (most common)
HTN
what possibly mediates glomerular capillary HTN?
how?
angiotensin II
vasoconstriction of efferent arterioles
wheret does vasoconstriction of efferent arterioles increase pressure?
in glomerular capillaries (glomerular capillary HTN)
what are some symptoms of CKD
- Cold intolerance
- Cramps and muscle pain
- SOB
- Puritus
- Edema
what are some signs of CKD?
- Acidosis
- Worsening HTN
- Anemia
- Secondary hyperparathyroidism
- Hyperkalemia
what is the goal level to decrease albuminuria to delay CKD progression
decrease albuminuria by 30%-50%
what are best agents for reducing albuminuria
ACEI and ARBs
why should ACEI’s and ARB’s not be recommended together
increased risk of hyperkalemia and renal dysfunction
what is the 2nd line tx for decreasing albuminaria in CKD?
what are these first line for
nondihydropyridine CCBs (diltiazem and verapamil) CKD in pregnancy
at what level should a protein restriction of .8g/kg/day be recommended?
GFR less than 30
what is BP goal if pt. has CKD, DM and no microalbuminuria
140/80
what is BP goal if pt. has CKD and no microalbuminuria (no DM)
140/90
what is BP goal if pt. has CKD, DM and microalbuminuria
130/80 (same as w/out DM)
what is BP goal if pt. has CKD and microalbuminuria (no DM)
130/80 (same as w/ DM)
what is considered a primary goal and a secondary goal:
control BP and control mircoalbuminaria
primary = control BP secondary = control microalbuminaria
What is 2nd line for BP control in CKD
Add diuretic (to 1st line ACE/ARB)
what type of diuretic is best for BP control if GFR is less than 30?
loop diuretics
what is the hemoglobin A1C target for glycemic control in CKD?
7%
