Complications of CKD

Question 1

What are the GFRs for each stage of CKD?

Answer 1

CKD 1 >90
CKD 2 60-89
CKD 3a 45-59
CKD 3b 30-44
CKD 4 15-29
CKD 5 < 15

Question 2

What urine ACR is microalbuminuria?

Answer 2

male 2.5-25mg/mmol

female 3.5-35mg/mmol

Question 3

What urine ACR is macroalbuminuria?

Answer 3

male > 25mg/mmol

female > 35mg/mmol

Question 4

What are the target blood pressures for patients with CKD?

Answer 4

<140/90 without albuminuria

<130/80 with albuminuria

Question 5

What Hb is required for a diagnosis of anaemia?

Answer 5

<120 in males < 110 in females

Question 6

What are the causes of anaemia in CKD?

Answer 6

iron deficiency, anaemia of chronic disease, lack of EPO

Question 7

What is the management for anaemia in CKD?

Answer 7

optimise iron stores (IV preferable)
use ESA with caution
target Hb 100-115
avoid PRBC transfusion

Question 8

What are HIF-propyl-hydroxylase inhibitors or stabilisers?

Answer 8

new drugs which cause an increase in HIF (hypoxia-inducible-factor) which increases endogenous EPO production - currently in trial for anaemia in CKD

Question 9

What causes acidosis in CKD?

Answer 9

lose ability to synthesise ammonia and lose ability to excrete hydrogen

Question 10

What is the treatment for acidosis?

Answer 10

sodium bicarbonate

Question 11

What is veverimer?

Answer 11

a hydrochloric acid binder, currently in trials for CKD

Question 12

What causes hyperkalaemia in CKD?

Answer 12

lower clearance of potassium, iatrogenic due to ACE/ARB

Question 13

What is the management of hyperkalaemia?

Answer 13

reduce/stop ACE/ARB
potassium binder (resonium)

Question 14

What is patiromer?

Answer 14

no absorbable polymer that exchanges potassium for calcium

Question 15

What is sodium sicornium cyclosilicate?

Answer 15

a selective cation that exchanges potassium for sodium and hydrogen