Consequences of CKD Flashcards
Why is dialysis the absolute last resort
There is an increase of cardiovascular disease once on dialysis
What are non-CKD related risk factors for cardiovascular disease
Diabetes, Hypertension, Hyperlipidemia
What are CKD related risk factors for cardiovascular disease
CKD, volume overload, Anemia, Mineral bone disease
T/F: Keeping blood pressure at goal is the best way to preserve renal function, especially of proteinuria is present
True
What should blood pressure be at home for dialysis patients, during dialysis
135/85, 140/90
What are non pharmacological treatments to keep blood pressure ideal during dialysis
weight loss, salt restriction to less than 2 grams per day, DASH diet, fluid restriction
What diseases and features will be present in Na-oliguria
Edema, hypertension, congestive heart failure
What foods are high in sodium
meats, frozen dinners, Asian sauces, Soup, restaurants
What is dry weight
Estimated weight that a patient would be at if their kidneys were fully functional
T/F: If a patient has left ventricular hypertrophy, fluid is more effective in reducing left ventricular hypertrophy than lowering blood pressure with medications
True
What is the water restriction for patients who have CKD, CKD on dialysis
2 liter per day, less than 4% of their estimated dry weight
What is the cornerstone of therapy for all CKD stages
ACE inhibitors and ARBs
Once ACEs and ARBs are at max doses what other classes of medications can be used to control blood pressure
Beta-blockers, calcium channel blockers, vasodilators, alpha adrenergic agonists
T/F: If a patient is on dialysis they are no longer able to make urine
False: Patients can still make urine due to residual renal function
What class of diuretics will not be used once the GFR is less than 40ml/min/1.73m2
Thiazides
What is the diuretic class that is best for patients on dialysis, when would a patient no longer use diuretics in dialysis
Loop diuretics, less than 500ml per day
How can hyperkalemia occur in CKD patients
sudden decrease in urine output, metabolic acidosis, diet, blood transfusion, medications
What is the best way to reduce risk of hyperkalemia in dialysis patients
Diet
What are foods that are high in potassium
oranges, bananas, melons, potatoes, tomatoes, dried beans
What medications can cause hyperkalemia in dialysis and should be discontinued
ACEs and ARBs, potassium sparing diuretics, succinyl choline, beta antagonists, digoxin, penicillin
What are medications used to treat hyperkalemia
Sodium polystyrene sulfonate, Patiromer, sodium zicron cyclosilicate
What are the two drugs that may decrease risk of hyperkalemia but uses sodium for cation exchange in dialysis
sodium zicron cyclosilicate and sodium polystyrene sulfonate
How long should sodium polystyrene sulfonate be seperated from other medications, patiromer, sodium zicron cyclosilicate
3 hours, 3 hours, 2 hours
T/F: The hyperkalemic agents should be avoided in patients who have bowel obstruction
True
