Class: caring for pts with CKD Flashcards
What stage/description CKD is GFR >90
stage 1 = kidney damage with normal GFR
What stage/description CKD is GFR 15-30
stage 4 = severe GFR
What stage/description CKD is GFR 60-89
stage 2 = mild kidney damage
What stage/description CKD is GFR 45-59
stage 3A mild/moderate kidney damage
What stage/description CKD is GFR 30-45
STAGE 3B = moderate kidney damage
kidney failure is what GFR
< 15 OR DIALYSIS
CKD-EPI Cystatin C test for measuring GFR isn’t affected by what parameter?
Muscle mass
describe the cutoff values for ALbumin excretion rates that apply to categories A1, A2, A3
A1 < 30 excreted/day
A2 = 30-300
A3 >300
CKD is defined as…
GFR <60
what is #1 cause of CKD in US
Diabetic Nephropathy
2 -5 cause of CKD =
HTN, other, Glomerulonephritis, Cystic Kidney
target BP for non-proteinuric disease
< 140/90
target BP for any proteinuric disease
< 130/80
What drugs are prescribed for CKD (2)
ACEIs, ARBs
What level of proteinuria are ACEIs and ARBs prescribed for in diabetics and non-diabetics?
diabetics >30/day
non-DM > 300/day
What is target HbA1C for CKD pts
7%
What pts are recommended to avoid high protein diet
those at risk for progression to CKD
Biopsy every pt with glomerular disease (to dx and treat) except which two pops
kids with MCD
Suspected IgA nephropathy with minimal proteinuria
MOA for how GFR causes high CVD mortality
Decreased GFR –> decrease in vascular compliance –> vascular calcification
MOA for how albuminuria/proteinuria causes CVD
Increased proteinuria–> atherosclerotic disease
What is the relationship between Albumiuria and CKD in CVD risk?
they are independent risk factors for CVD
how to tx mtb acidosis in CKD pts
add sodium bicarbonate
5 comorbidities of CKD
hyperkalemia anemia (EPO production) volume overload (hyperactive RAAS) metabolic acidosis bone disease: hyperphosphatemia, vitamin D deficiency
What 3 drugs are risky in CKD
NSAIDs Insulin (partially excreted by kidney- need to reduce dose) Metformin - avoid beyond stage 3A
