Final of CKD

Question 1

________________ is common in individuals with diabetes and CKD

Can be an independent predictor not only of cardiovascular disease but also of the progression of CKD

Answer 1

Hyperlipidemia

Question 2

Hyperlipidemia in CKD

_________decrease mortality and cardiovascular events
in patients with early-stage CKD

Not as much evidence in patients with ESRD on dialysis

Answer 2

Statins

Question 3

Goals for pts with CKD for cholesterol levels?

LDL level would be what?

Answer 3

LDL of less 70

Question 4

Having chronic kidney disease is a risk enhancing factor for hyperlipidemia?

Question 5

Chronic is a risk enhancing factor for ASCVD

Question 6

Pts with CKD stage 3 or greater with albuminuria we are more aggressive and LDL is less than 70

Question 7

what is a potent statin that are not renally dose adjusted used for pts with hyperlipidemia with CKD

Answer 7

atorvastatin

Question 8

What are microvascular complications? peripheral neuropathy,retinopathy, nephropathies (impact on the kidneys)

Question 9

What are macrovasular complications?
heart attack, stroke

Question 10

Intensive treatment of hyperglycemia prevents elevated albuminuria or delays its progression

Reduces microvascular complications of diabetes

Question 10

A1C of less than 6.5% is more stringent

A1C of less than 8% is less stringent

Which depends on the severity of CKD for pt, do they have macrovascular complications (have they have a heart attack or stroke), do they alot of comorbodites, whats their life expectancy, resources for hypoglycemia, do they have social support, are they on alot of drugs that cause hypoglycemia

Question 10

We lare ess strigent on older folks for A1C depending goals versus earlier onset pt with less comorbodities or whose younger and has a long time to live

Question 11

CKD Stage G1(A1C less than 6.5%) vs G3 (in the middle) vs G5 (less strigent of less than 8%)

Question 12

On exam will have to decide it pt’s A1C goal is less than 6.5% or less than 8% ….like are you saying less 6.5% because they are stage G3 and they have a decent life expectancy not too many cormodities, have a decent understanding of hypoglycemia, they have a lot of support

Question 13

Hypoglycemia risk

Risk increases in patients with substantial decreases in eGFR (CKD stages 4 and 5)

Decreased clearance of _________ and some of the oral agents

Impaired renal gluconeogenesis with reduced kidney mass

Monitor glucose levels closely and reduce doses of medications

Answer 13

insulin