DM Flashcards
When does CKD develope in Type 1 DM, and Type 2?
after diabetes duration of 10 years
at diagnosis for Type 2
What TESTS OF KIDNEY FUNCTION?
- Serum Creatinine
* Creatinine Clearance/GFR
WHAT TESTS TO DETECT PROTEINURIA?
Urine Albumin : Urine Creatinine ratio
In adults with DM how often should creatinine be checked?
annually
What would happen to the value of creatinie with kindney dysfunction?
Rises with decreased kidney function because it is clearing less of it
What is creatinine clearance used for ?
and What would happen to the level with kidney dysfunction?
To estimate glomerular filtration rate (GFR), using CKD-EPI equation
Lowers with decreased kidney function or failure, filtration rate is low
Where is albumin made and how much of it makes up plasma. Should you see it in urine?
made in liver
2/3 of plasma is albumin
abnormal to have any protein in urine
What is “Moderately Increased” albuminuria and what is it an indicator of ?
EARLY indicator of diabetic nephropathy
30-300 mg/24 hrs
What is “Severely Increased” albuminuria and what is it an indicator of ?
LATE indicator of diabetic nephropathy
“Very High”: >300 mg/24 hours
UrineAlbumin: Creatinine Ratio is preferrred for what ? When should the specimen be collected ?
It is the preferred method for detecting moderately increased albuminuria
Early morning (“first-voided”) urine specimen preferred
How many UACRs must be be abnormal and over what period to classify alubuminuria ?
At least 2 out of 3 collections over a 3-to 6- months must be abnormal before diagnosing albuminuria
What does the timed Test for Albuminuria measure ? is it more or less specific and sensitive than urine dipstick?
urinary albumin excretion rates
More sensitive and specific
How might a urine timed test for albuminuria yeild false positives or negatives?
- Decreases in urine volume could increaseurinealbuminconcentration
- Increases in urine volume could decrease urine albumin concentration
