Paulson - Kidneys 102 Flashcards by Alice Richards

kidney damage or decreased kidney fxn for 3 or more months

ckd

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2 mc causes of ckd

HTN

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leading cause of death in CKD pt’s

CVD

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rf for ckd (lots!)

60 yo or older

htn

CVD

fh ckd

recurrent UTIs

previous AKI

nephrolithiasis

transplant

smoking

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creatinine is a product of __ metabolism

and is excreted by __

muscle

kidneys

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nl Cr

0.6-1.2 mg/dl

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GFR represents

plasma filtration by glomerulus

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nl GFR

90 ml/min/1.73 m2 or higher

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gs measurement for gfr

inulin clearance

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2 equations used for GFR measurement

MDRD

cockroft-gault

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which GFR equation should NOT be used in AKI pt’s

MDRD

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IBW should be used in GFR equations for (2)

obese

fluid overloaded

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all types of proteins that might be in urine

proteinuria

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nl proteinuria

less than 150 mg/dl

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gold standard proteinuria measurement

24 hr urine → urine protein to creatinine ratio

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causes of proteinuria

tubular damage

diabetic nephropathy

glomerulonephritis

rhabdo

bence-jones proteins

exercise

orthostatic proteinuria

acute sickness

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proteinuria that is specific to CKD and pathopgnomonic to kidney damage

albuminuria

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test that detects early CKD

albuminuria

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preferred screening for albuminuria

yearly urine albumin to Cr ratio

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nl albuminuria

less than 30 mg/d

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microalbuminuria parameter

30-300 mg/day

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macroalbuminuria parameter

higher than 300 mg/day

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higher albuminuria is associated w.

quicker progression to kidney failure

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tx for early detection of moderate-severe albuminuria in diabetics

ACEI

ARB

→ decrease amt of albuminuria

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CKD stages factor in (2)

GFR albuminuria (albumin:Cr ratio)

classification of CKD using GFR and ACR categories gives info about

risk of adverse outcomes

ACR indicative of normal-mildly increased risk

A1: less than 3

ACR indicative of moderately increased risk

A2: 3-30

ACR indicative of severely increased risk

A3: 30 or higher

diagnostic test for CKD

normal kidney size on US

10 cm

what US finding suggests CKD

shrunken kidney

US can help differentiate btw \_\_ and __ kidney issues

acute chronic

common meds that need renal dosing

NSAIDs contrast Mg (laxatives) phosphorous (Fleet's enemas) aluminium (maalox, rolaids) antimicrobials diabetic meds decongestants antihypertensives opioids gabapentins

7 complications of ckd

htn hyperphosphatemia hyperparathyroidism anemia hyperkalemia acidosis uremic encephalopahy

tx for hyperphosphatemia (2)

phosphate binders → sevelgmer diet

tx for hyperprathyroidism

vit D

tx for anemia

erythropoietin argnesp iron supplements

goal for hgb in ckd

10-11

tx for hyperkalemia (3)

**diet** **kayexelate** **dialysis** albuterol Ca insulin

serum K \> __ indicates hyperkalemia

sx of hyperkalemia

intestinal colic diarrhea muscle weakness paralysis

ekg findings of hyperkalemia

peaked t waves cardiac dysrhythmia

indications for dialysis (3)

gfr 10-15 unable to control volume status hyperkalemia

what is an avf

arteriovenous fistula

avf takes __ months to mature

types of dialysis (2)

hemodialysis (HD) peritoneal (PD)

which dialysis is given 3x/week

types of PD

continuous ambulatory (CAPD) continuous cyclic (CCPD)

CAPD is given

4-5 x/day

CCPD is given

at night while asleep

squamous epithelial cells on urine microscopy suggest

contaminated sample

renal tubular cells/casts on urine microscopy suggest

ATN or AIN

RBC casts on urine microscopy suggest

**glomerulonephritis** AIN vasculitis

WBC casts in urine microscopy suggest

interstitial nephritis pyelonephritis inflammation

fatty casts on urine microscopy suggest

nephrotic syndrome

hyaline casts can be

normal

muddy brown casts on urine microscopy suggest

ATN

quad of nephrotic syndrome

**edema** **foamy urine → massive proteinuria** **hypoalbuminuria** **hyperlipidemia** peripheral edema

causes of nephrotic syndrome (4)

DM minimal change dz fsgs (focal segmental glomerular sclerosis) membranous nephropathy

nephritic syndrome triad

**htn** **hematuria** **proteinuria →** ***less than nephrotic syndrome*** coca cola urine glomerulonephritis oliguria

3 causes of nephritic syndrome

post-infectious glomerulonephritis IgA nephropathy membranoproliferative glomerulonephritis