Kidneys: Part 2 (paulson) Flashcards
Chronic Kidney Disease (CKD) is kidney damage or decreased kidney function for ___ months
≥ 3 months
CKD:
-MC causes?
- Diabetes
- HTN
Why we care about CKD?
- 59% of Americans develop CKD 3 or higher during life
- About 50% of those with CKD will have an occurrence of AKI
___% of high risk patients with CKD are not identified
90%
–Leading cause of death in CKD patients
CKD patients are at increased risk for ________ disease
Cardiovascular disease
–CV is the leading cause of death in CKD patients
Risk Factors for CKD
>60 years old HTN Diabetes CV disease FH of CKD Recurrent UTIs Previous AKI Nephrolithiasis Transplant Autoimmune Disease Smoking
Creatinine= a product of _____
muscle metabolism, excreted by kidneys
Creatinine
-normal range?
0.6-1.2 mg/dl
GFR=
Plasma filtration by glomerulus (aka creatinine clearance)
Normal GFR
> 90 ml/min/1.73m2
What is the gold standard for measuring GFR?
**insulin clearance
Other methods of measuring GFR
MDRD and Cockcroft-Gault equations commonly used
MDRD should not be used in Pts with _____
AKI
Cockgroft equation requires:
Remember to use IBW in obese or fluid overloaded patients
Cockgroft requires gender, Age, weight, to calculate Creatinine clearance
Proteinuria=
Refers to all types of proteins that might be in urine
Normal level of protein in urine
<150 mg/d.
Gold standard test for Proteinuria
** 24 hour urine –>Urine protein to creatinine ratio
Proteinuria:
-etiology?
-Tubular damage, diabetic nephropathy, glomerulonephritis, rhabdo, Bence Jones proteins
Less concerning causes: exercise, orthostatic proteinuria, acute sickness
Albuminuria is specific to ____
**CKD
albuminuria is pathopneumonic for _____
kidney damage
Albuminuria can be detected before changes in ______ function occur
renal
-**(detects early CKD)
Albuminuria:
-what is the preferred screening test?
- Urine albumin to creatinine ratio preferred screening
- Yearly screening recommended