Class: caring for pts with CKD

Question 1

What stage/description CKD is GFR >90

Answer 1

stage 1 = kidney damage with normal GFR

Question 2

What stage/description CKD is GFR 15-30

Answer 2

stage 4 = severe GFR

Question 3

What stage/description CKD is GFR 60-89

Answer 3

stage 2 = mild kidney damage

Question 4

What stage/description CKD is GFR 45-59

Answer 4

stage 3A mild/moderate kidney damage

Question 5

What stage/description CKD is GFR 30-45

Answer 5

STAGE 3B = moderate kidney damage

Question 6

kidney failure is what GFR

Answer 6

< 15 OR DIALYSIS

Question 7

CKD-EPI Cystatin C test for measuring GFR isn’t affected by what parameter?

Answer 7

Muscle mass

Question 8

describe the cutoff values for ALbumin excretion rates that apply to categories A1, A2, A3

Answer 8

A1 < 30 excreted/day
A2 = 30-300
A3 >300

Question 9

CKD is defined as…

Answer 9

GFR <60

Question 10

what is #1 cause of CKD in US

Answer 10

Diabetic Nephropathy

Question 11

2 -5 cause of CKD =

Answer 11

HTN, other, Glomerulonephritis, Cystic Kidney

Question 12

target BP for non-proteinuric disease

Answer 12

< 140/90

Question 13

target BP for any proteinuric disease

Answer 13

< 130/80

Question 14

What drugs are prescribed for CKD (2)

Answer 14

ACEIs, ARBs

Question 15

What level of proteinuria are ACEIs and ARBs prescribed for in diabetics and non-diabetics?

Answer 15

diabetics >30/day

non-DM > 300/day

Question 16

What is target HbA1C for CKD pts

Answer 16

7%

Question 17

What pts are recommended to avoid high protein diet

Answer 17

those at risk for progression to CKD

Question 18

Biopsy every pt with glomerular disease (to dx and treat) except which two pops

Answer 18

kids with MCD

Suspected IgA nephropathy with minimal proteinuria

Question 19

MOA for how GFR causes high CVD mortality

Answer 19

Decreased GFR –> decrease in vascular compliance –> vascular calcification

Question 20

MOA for how albuminuria/proteinuria causes CVD

Answer 20

Increased proteinuria–> atherosclerotic disease

Question 21

What is the relationship between Albumiuria and CKD in CVD risk?

Answer 21

they are independent risk factors for CVD

Question 22

how to tx mtb acidosis in CKD pts

Answer 22

add sodium bicarbonate

Question 23

5 comorbidities of CKD

Answer 23

hyperkalemia
anemia (EPO production)
volume overload (hyperactive RAAS)
metabolic acidosis
bone disease: hyperphosphatemia, vitamin D deficiency

Question 24

What 3 drugs are risky in CKD

Answer 24

NSAIDs
Insulin (partially excreted by kidney- need to reduce dose)
Metformin - avoid beyond stage 3A

Question 25

5 reasons for Dialysis

Answer 25

Acidosis
Electrolyte imbalance (high K+)
Ingestion (n/a in CKD)
Overload (refractory to diuretics
Uremia (BUN > 100)

Question 26

1 year mortality on dialysis = ?

Answer 26

20%

Question 27

5 year survival on dialysis = ?

Answer 27

35%

Question 28

5-year survival of kidney transplant

Answer 28

70-90%