Class: caring for pts with CKD Flashcards

1
Q

What stage/description CKD is GFR >90

A

stage 1 = kidney damage with normal GFR

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2
Q

What stage/description CKD is GFR 15-30

A

stage 4 = severe GFR

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3
Q

What stage/description CKD is GFR 60-89

A

stage 2 = mild kidney damage

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4
Q

What stage/description CKD is GFR 45-59

A

stage 3A mild/moderate kidney damage

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5
Q

What stage/description CKD is GFR 30-45

A

STAGE 3B = moderate kidney damage

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6
Q

kidney failure is what GFR

A

< 15 OR DIALYSIS

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7
Q

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

A

Muscle mass

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8
Q

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

A

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

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9
Q

CKD is defined as…

A

GFR <60

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10
Q

what is #1 cause of CKD in US

A

Diabetic Nephropathy

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11
Q

2 -5 cause of CKD =

A

HTN, other, Glomerulonephritis, Cystic Kidney

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12
Q

target BP for non-proteinuric disease

A

< 140/90

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13
Q

target BP for any proteinuric disease

A

< 130/80

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14
Q

What drugs are prescribed for CKD (2)

A

ACEIs, ARBs

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15
Q

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

A

diabetics >30/day

non-DM > 300/day

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16
Q

What is target HbA1C for CKD pts

A

7%

17
Q

What pts are recommended to avoid high protein diet

A

those at risk for progression to CKD

18
Q

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

A

kids with MCD

Suspected IgA nephropathy with minimal proteinuria

19
Q

MOA for how GFR causes high CVD mortality

A

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

20
Q

MOA for how albuminuria/proteinuria causes CVD

A

Increased proteinuria–> atherosclerotic disease

21
Q

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

A

they are independent risk factors for CVD

22
Q

how to tx mtb acidosis in CKD pts

A

add sodium bicarbonate

23
Q

5 comorbidities of CKD

A
hyperkalemia
anemia (EPO production)
volume overload (hyperactive RAAS)
metabolic acidosis
bone disease: hyperphosphatemia, vitamin D deficiency
24
Q

What 3 drugs are risky in CKD

A
NSAIDs
Insulin (partially excreted by kidney- need to reduce dose)
Metformin - avoid beyond stage 3A
25
Q

5 reasons for Dialysis

A
Acidosis
Electrolyte imbalance (high K+)
Ingestion (n/a in CKD)
Overload (refractory to diuretics
Uremia (BUN > 100)
26
Q

1 year mortality on dialysis = ?

A

20%

27
Q

5 year survival on dialysis = ?

A

35%

28
Q

5-year survival of kidney transplant

A

70-90%