Renal Flashcards
A patient with stage 4 chronic kidney disease (CKD) has been advised to follow a low-protein diet. What is the primary reason for this recommendation?
A) To prevent protein-energy wasting and preserve muscle mass
B) To minimize nitrogenous waste and delay progression to end-stage renal disease (ESRD)
C) To promote diuresis and control fluid overload
D) To prevent metabolic acidosis and maintain electrolyte balance
To minimize nitrogenous waste and delay progression to end-stage renal disease (ESRD)
A patient with acute kidney injury (AKI) is oliguric and has a serum potassium of 6.2 mEq/L. Which of the following dietary recommendations is most appropriate?
A) Provide a high-protein, low-potassium diet to prevent catabolism
B) Restrict potassium to ≤2000 mg/day and monitor fluid intake
C) Increase potassium intake to compensate for losses
D) Provide a high-carbohydrate, high-potassium diet to maintain energy balance
Restrict potassium to ≤2000 mg/day and monitor fluid intake
For a patient on hemodialysis, which of the following is the most appropriate protein recommendation?
A) 0.6-0.8 g/kg/day to minimize nitrogen accumulation
B) 1.2-1.4 g/kg/day to compensate for protein losses during dialysis
C) 1.0-1.2 g/kg/day to maintain nitrogen balance
D) 0.8-1.0 g/kg/day to prevent hyperkalemia
1.2-1.4 g/kg/day to compensate for protein losses during dialysis
A patient with CKD and hyperphosphatemia is not responding to phosphate binders. Which dietary intervention should be prioritized?
A) Restrict dairy products and processed foods high in phosphorus
B) Increase intake of plant-based phosphorus sources
C) Encourage a high-protein diet to offset muscle wasting
D) Restrict potassium and sodium to maintain electrolyte balance
Restrict dairy products and processed foods high in phosphorus
Which of the following is the best strategy to manage fluid overload in a patient on hemodialysis?
A) Restrict sodium to ≤2000 mg/day and monitor fluid intake
B) Increase potassium intake to promote diuresis
C) Limit protein intake to reduce nitrogenous waste
D) Provide high-sodium oral nutrition supplements to replace losses
A) Restrict sodium to ≤2000 mg/day and monitor fluid intake
A 68-year-old patient with diabetic nephropathy and stage 3 CKD presents with anemia. What is the most likely cause of this condition?
A) Decreased erythropoietin production
B) Chronic inflammation causing iron deficiency
C) Low protein intake leading to malnutrition
D) Vitamin B12 deficiency due to impaired absorption
A) Decreased erythropoietin production
Which of the following micronutrients is most likely to be deficient in a patient on long-term hemodialysis?
A) Vitamin A
B) Vitamin D
C) Iron
D) Vitamin C
B) Vitamin D
For a patient with peritoneal dialysis (PD), what is the most significant nutritional challenge compared to hemodialysis (HD)?
A) Increased risk of fluid overload
B) Higher protein loss and need for increased protein intake
C) Risk of hyperkalemia due to potassium absorption
D) Increased need for phosphorus restriction
B) Higher protein loss and need for increased protein intake
Which of the following dietary interventions is recommended to prevent hyperkalemia in patients with CKD stage 5?
A) Encourage consumption of potassium-rich fruits and vegetables
B) Limit intake of potassium to ≤2000 mg/day
C) Increase protein intake to prevent catabolism
D) Promote high-sodium intake to balance potassium levels
B) Limit intake of potassium to ≤2000 mg/day
A patient with CKD stage 3 and metabolic acidosis should receive which of the following interventions?
A) Low-protein diet to reduce acid load
B) Sodium bicarbonate supplementation to correct acidosis
C) Increase potassium intake to buffer acid
D) High-carbohydrate diet to provide alkaline precursors
B) Sodium bicarbonate supplementation to correct acidosis
62-year-old male with CKD stage 4 secondary to hypertension
Reports poor appetite and fatigue
Medications: Lisinopril, calcium acetate
Lab Values:
Serum potassium: 5.8 mEq/L
Serum phosphorus: 6.2 mg/dL
Albumin: 3.5 g/dL
Question:
What is the most appropriate dietary intervention for this patient?
A) High-protein, low-phosphorus diet with potassium restriction
B) Low-protein, low-potassium, low-phosphorus diet
C) High-potassium, high-protein diet with phosphorus binders
D) Liberal protein intake with fluid restriction
B) Low-protein, low-potassium, low-phosphorus diet
55-year-old female with end-stage renal disease (ESRD) on hemodialysis 3x/week
Complains of muscle cramps and dry skin
Lab Values:
Serum calcium: 8.1 mg/dL
Phosphorus: 5.9 mg/dL
PTH: Elevated
Question:
What is the most appropriate dietary recommendation?
A) Increase dietary calcium and reduce phosphorus intake
B) Provide a high-phosphorus diet to compensate for losses
C) Restrict protein intake to prevent hyperphosphatemia
D) Increase potassium intake to prevent muscle cramps
A) Increase dietary calcium and reduce phosphorus intake
45-year-old male with AKI secondary to sepsis
Oliguric with poor urine output and elevated BUN and creatinine
Currently receiving enteral nutrition
Lab Values:
Serum potassium: 6.4 mEq/L
Phosphorus: 5.8 mg/dL
Albumin: 3.2 g/dL
Question:
What is the most appropriate modification to his enteral feeding regimen?
A) Switch to a low-protein formula with restricted potassium and phosphorus
B) Provide a high-protein, low-potassium, low-phosphorus formula
C) Increase fluid intake to promote diuresis and reduce potassium
D) Add potassium supplements to prevent deficiency
A) Switch to a low-protein formula with restricted potassium and phosphorus
70-year-old female with CKD stage 5 and type 2 diabetes
On peritoneal dialysis (PD)
Reports weight gain and increased thirst
Lab Values:
Serum glucose: 180 mg/dL
Serum potassium: 4.8 mEq/L
Serum phosphorus: 5.0 mg/dL
Question:
What is the most appropriate dietary intervention for this patient?
A) Low-glycemic index diet with moderate protein and potassium restriction
B) High-protein, low-potassium diet with increased fluid intake
C) Low-carbohydrate diet with phosphorus supplementation
D) High-fiber, low-protein diet with potassium supplements
A) Low-glycemic index diet with moderate protein and potassium restriction
60-year-old male with diabetic nephropathy and CKD stage 3
Complains of fatigue and tingling in extremities
Lab Values:
Hemoglobin: 10.2 g/dL
Ferritin: 220 ng/mL
Transferrin saturation: 18%
Question:
What is the most appropriate intervention?
A) Oral iron supplementation and evaluation for erythropoiesis-stimulating agent (ESA)
B) High-protein diet to improve nitrogen balance
C) Increase vitamin B12 intake to prevent neuropathy
D) Restrict potassium and phosphorus to prevent progression
A) Oral iron supplementation and evaluation for erythropoiesis-stimulating agent (ESA)
50-year-old male with AKI due to rhabdomyolysis
Receiving continuous renal replacement therapy (CRRT)
Lab Values:
BUN: 35 mg/dL
Serum potassium: 5.1 mEq/L
Albumin: 2.8 g/dL
Question:
What is the most appropriate protein recommendation?
A) 0.8-1.0 g/kg to prevent nitrogen accumulation
B) 1.2-1.5 g/kg to support protein turnover and prevent catabolism
C) 1.0-1.2 g/kg with potassium restriction
D) 0.6-0.8 g/kg with phosphorus restriction
B) 1.2-1.5 g/kg to support protein turnover and prevent catabolism
