Renal

Question 1

CKD I - NKF Classification

Answer 1

• GFR >90 despite kidney damage

- microalbuminuria

Question 2

CKD II

Answer 2

• GFR 60-89,
• mild reduction
• GFR 60 = 50% loss of function
• PTH starts to inc

Question 3

CKD III

Answer 3

• GFR 30-59
• a 45-59, b 30-44
• Moderate reduction
• Ca absorption decreased
• malnutrition onset
• anemia 2/2 EPO def
• Left Ventricular hypertrophy

Question 4

CKD IV

Answer 4

• GFR 15- 29
• severe reduction
• Inc TG
• Hyperphosphatemia
• Metabolic Acidosis
• HyperK

Question 5

CKD V

Answer 5

• GFR <15
• Kidney failure
• Azotemia

Question 6

CKD Causes

Answer 6

DM 37 %
HTN 30 % (inc in AA)
HIV
Glomerulonephritis 20% (inc SLE)
Hereditary (PCKD 7%, alport synd, medullary cystic dz)
Tublointerstitial dz 4% (infx w/ scarring, obstruction, meds)

Question 7

CKD Criteria

Answer 7

• GFR <60 (2 calc 3 months apart) Male Cr 1.5, Female Cr 1.3
• Proteinuria or albuminura for >3 months, Ur alb to Cr ratio >30mg/g, ur alb >300 (mod)
• Structural kidney dz for >3 month (u/s)
• All renal transplant have CKD regardless of GFR or proteinuria

Question 8

Renal Bx Indic/Contraindinc

Answer 8

Indications:
- Hematuria and low Cr clearance or proteinuria
- Nephrotic range proteinuria
- Chronic renal failure with nl or large kidneys
- Acute renal failure of unkn cause
Contraindications:
- Renal length <9cm
- Severe HTN
- Mltp large renal cysts
- Uncorrected bleeding tendency
- Hydronephrosis
- Acute infx

Question 9

Meds limitations for GFR <30 (IV)

Answer 9

Metformins, Flozins
Biphosphonates
Direct OAC
NSAIDs
Bowel prep use PEG insteaf of mag or phosphorus preps