Renal Flashcards

1
Q

CKD Definition

A
  • structural or functional kidney abnormalities for at least 3 months (most commonly persistent proteinuria) or eGFR < 60 mL/min
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2
Q

CKD Stages

A
  • Stage I: eGFR > 90 and persistent albuminuria
  • Stage II: eGFR 60-89 and persistent albuminuria
  • Stage III: eGFR 30-59
  • Stage IV: eGFR 15-29
  • Stage V: eGFR <15
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3
Q

New onset CKD tests

A
  • U/A, CBC, GBCL, ACR, A1C, lipids, abdo US
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4
Q

CKD Tx

A
  • Statin for LDL < 2 for all
  • HTN, DM management, smoking cessation, stop NSAIDS, hydrate, r/o obstruction
  • Monitor ACR
  • target to <40
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5
Q

CKD when to start dialysis

A
  • eGFR up to 6 OK to hold off if not hyperkalemia non-uremic and asymptomatic, but generally < 15 start dialysis
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6
Q

When to refer CKD

A
  • Stage IV
  • progressive decline eGFR
  • AKI
  • cannot get patient to target values
  • ACR > 60 (>500mg/24h)
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7
Q

By how much does Cr increase per day in the absence of renal function?

A
  • 80-250 mmol/L per day
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8
Q

Contrast-induced nephropathy protocol

A
  • Merten Protocol
    • 3 amps bicarb in 1 L D5W
      • 3 mL/kg bolus
      • image
      • then 1 mL/kg/h x 6h
  • Hold Metformin for 48h
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9
Q

Indications for Emergent Dialysis

A
  • uncontrolled K+ of 6.5 or rising
  • intractable fluid overload
  • uremic pericarditis
  • progressive uremic encephalopathy
  • Na <115 or >165
  • severe metabolic acidosis with AKI
  • life threatening poisoning with Li, aspirin, methanol, ethylene glycol, theophylline
  • bleeding dyscrasia from uremia
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10
Q

Treatment of Rhabdo

A

Review Evernote

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