ckd4 Flashcards
what are goal calcium levels in stage 3-5 CKD
stage 3 and 4 = 8.5-10.5
stage 5 = 8.4-9.5
what is the goal phosphorous levels in stage 3-5 CKD
stage 3 and 4 = 2.7-4.6
stage 5 = 5.5
what is 1st line tx of CKD MBD
calcium containing K binders
what are the doses of sevelamer?
how should it be taken
intitial = 800 mg TID w/ meals
Max 1600 mg TID w/ meals
what is decreased by sevelamer
cholesterol
what level of Ca-phos product is Sevelamer normally started
> 55
what mus be evaluated before starting Vit D in CKD?
hyperphosphatemia
hypocalcemia
vit D def.
what is best measure of Vit D status
25(OH)D (25-hydroxyvitamin D3)
what levels of 25(OH)D are normal, insufficient or deficient?
normal = greater than 30 insufficient = 16=-0 deficient = less than 15
what is first line for vit D deficiency in CKD
calcitriol
what are two Vit D analogs
Paricalcitol
Doxercalciferol
where is doxercalciferol activated
liver
when should vit D therapy be started in stage 3-4 CKD?
serum Ca less than 9.5
and Serum P less than 4.6
hold if eith increase above ths
what is initial dose of doxercalciferol in stage 3-4 CKD
2.5 mcg 3x’s a week
what should be monitored in Vit D therapy
calcium
phosphorous
estimated PTH
