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Nutrition Sum 2023 > Kidney and diet and stuffs > Flashcards

Kidney and diet and stuffs Flashcards

1
Q

AKI characteristics (acronym)

A

WADE
Waste product buildup
Abnormal volume status
Decreased eGFR
Electrolyte imbalance

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2
Q

accelerated protein breakdown

A

AKI
must increase protein intake!

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3
Q

must increase protein intake

A

AKI

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4
Q

eGFR <60

A

Chronic kidney disease if this persists for 3+ months

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5
Q

eGFR is 98, what stage

A

stage 1 = >90

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6
Q

eGFR is 62, what stage

A

stage 2 = 60-90

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7
Q

eGFR is 54, what stage

A

stage 3a = 45-59

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8
Q

eGFR is 43, what stage

A

stage 3b = 30-44

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9
Q

eGFR is 28, what stage

A

stage 4 = 16-29

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10
Q

eGFR is 12, what stage

A

stage 5 = <15

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11
Q

CKD affects which metabolic pathway (acronym)

A

P - FEN
Protein homeostasis and metabolism (may need protein restriction)

Feedback mechanisms (thirst, taste and appetite)

Energy homeostasis (especially in dialysis pts, may develop cachexia)

Nutrient metabolism (Ca, Iron, B,C,D vitamins, zinc, selenium, manganese and may cause aluminum toxicity.)

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12
Q

What are possible “treatments” for AKI

A
  • fluid replacement if hypovolemic
  • electrolytes will fix themselves
  • increase protein intake if AKI lasts longer than a few days (1.5-2.5 g/kg/day where normal is .8g/kg/day)
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13
Q

what are the structural or functional markers of kidney damage on:
Imaging
labs

A

imaging - polycystic kidneys, increased echogenicity, atrophy

labs - hematuria, proteinuria, abnormal “cast shedding” wtf is that idk

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14
Q

what are the feedback mechanisms that are altered in CKD

A

thirst, appetite, taste

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15
Q

what patients are more at risk for alteredenergy homeostasis in CKD? what might they develop?

A

hemodialysis patients
may develop cachexia

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16
Q

what nutrient metabolism is altered in CKD

A

Ca absrob decrease
Iron absorption decreased
B, C, D(active form) vitamin def
zinc, selenium, manganese def

at risk for aluminum toxicity

17
Q

describe the difference in protein intake in CKD vs AKI

A

CKD wants protein restriction to slow down deterioration of kidney function

AKI wants increased injury because there is increased protein metabolism

18
Q

what CKD patient actually needs increased protein? what are the two different types

A

dialysis patients
hemodialysis = 1-1.2 g/kg/day
peritoneal dialysis = 1.3g/kg/day

19
Q

hyperkalemia is seen when in this lecture

A

with PLADO diet for CKD

also in late stage CKD cuz patients cant excrete potassium

20
Q

in this diet you supplement AA, ketoacids and hydroxy acids and keep protein intake below .43 g/kg/day

A

very low protein diet w supplementation

21
Q

what food provides too much phosphate and potential acid load for CKD patients

A

animal proteins

22
Q

promotes nitrogen excretion and lowers inflammation

A

fiber

23
Q

this is associated with better mortality rates in CKD patients

A

high fiber intake

24
Q

high fat consumption can increase….

A

glomuler pressure
albuminuria

25
Q

what can you do to your foods to decrease potassium intake

A

boiling fruits and vegetables

26
Q

what foods have the highest PRAL

A

“potential renal acid load”

hard cheese and egg yolks

(animal based foods in general)

27
Q

what foods have the lowest PRAL

A

raisins and spinach
(plant based in general)

28
Q

how can we decrease a patients acid levels in CKD

A

have them eat 2-4 cups of fruits/veggies daily

supplement w sodium bicarbonate

29
Q

compare the absoprtion of organic v inorganic phosphorus

A

organic - natural in foods 30-60% absorb

inorganic - dark sodas, processed foods (preservative) - >90% absorbed

30
Q

how does CKD affect vitamin D in the body

(you literally know this, we talked about Vitamin D in the last endo exam with hyperparathyroidism just use your brain)

A

CKD = decreased converison of Vit D to active Vit D

this leads to decreased ca+ absoprtion in GI (hypyocalcemia!)

corrected w vitamin D replacement

31
Q

what supplementation may help with lipid levels in CKD

A

carnitine

32
Q

what minerals are decreased in CKD but are not recommended to supplement since the health outcome is not changed.

A

zinc/selenium

33
Q

how long does eGFR have to be under 60 for CKD to be diagnosed

A

3+ months

33
Q

what mineral is at risk for causing toxicity in CKD patients

A

aluminum

33
Q

what patients are more at risk for alteredenergy homeostasis in CKD? what might they develop?

A

hemodialysis patients
may develop cachexia

33
Q

what diet decreases protein intake to .6-.8 g/kg/day

A

plant-dominant low protein diet (PLADO)

34
Q

what stage is protein restriction started in CKD

A

stage 3-5 (.6-.8 g/kg/day PLADO)

Nutrition Sum 2023 (10 decks)

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