Nephrology Flashcards
what numbers diagnose AKI
rise of SCr by 26.5 within 48hrs or 1.5x baseline within 7 days
urine volume <0.5mL/kg/h for 6 hours
what is oliguria? what is anuria
oliguria <400ml urine/ d
anuria <100ml urine/ d
T or F: eGFR is reliable to diagnose AKI
F- eGFR not accurate in AKI
instead of using IBW in obese pts, ______ should be used. If the pt is <IBW, then use ________
obese = adjBW
<IBW = use ABW
how to prevent contrast induced AKI
pre and post op prophylaxis IV fluids
how to prevent perioperative AKI
hold RAAS antagonists
volume reduction/ prevention of hypotension
how to prevent AKI from cancer chemo and tumor lysis
hydration w/ IV fluids and allopurinol qd for a few days before chemo to prevent uric acid nephropathy
what is considered severe hyperkalemia? what should be the first step to monitor?
K >6.5
cardiac monitoring for ECG changes (if yes -= start Calcium gluconate)
what does calcium gluconate do in hyperkalemia
membrane stabilization in ECG changes
what should you do in hyperkalemia if there are no ECG changes
salbutamol or insulin + dextrose IV
(both if severe >6.5)
then sodium bicarb IV if acidosis
which agents shift K+ into cells
sodium bicarb, insulin, salbutamol
how does sodium polystyrene work in hyperkalemia
eliminates K with sorbitol
CKD is the progressive replacement of normal kidney structure with
interstitial fibrosis
what are the numbers for dx of CKD
3 mths
CFR <60 or ACR >3mg/mmol
presence of markers of kidney damage with =>3 mths w/ or without decrease in GFR
what is 1st line tx for BG control in CKD
metformin, SGLT2
metformin should be avoided if CrCL is <
30
what is 1st and 2nd line tx for BP control in CKD? what is the target?
1st = ACEi/ARB
2nd = DHP-CCB or diuretic
target 120
what are the 3 CKD complications
hyperphosphatemia
secondary hyperparathyroidism
anemia + iron def
waht is 1st line tx for hyperphosphatemia? what if the person had hypercalcemia as well?
calcium carbonate
hypercalcemia = noncalcium binders (sevelamer, lanthanum, sucroferric oxyhydroxide)
what is the tx for secondary hyperparathyroidism
vit D analoges (alfacalcidol, calcitriol)
calcium mimetics (cinacalcet)
T or F: cinacalcet has to be taken with food
T to improve bioavailability
when should ESAs be started in CKD? what is the target?
if Hb 90-100
target 110
what should be started before ESAs in CKD
iron to boost stores
what is the earliest responding lab value to iron tx
reticulocyte count
when to follow up about CKD
q3mths
