Renal Flashcards
A GFR of 15-29 indicates what stage of CKD?
Stage 4
A GFR of 60-89 indicates which stage of CKD?
Stage 2 (mild kidney damage)
A GFR of >90 with proteinuria indicates which stage of CKD?
Stage 1
A GFR of <15 indicates which stage of CKD?
Stage 5
A GFR of 30-59 indicates which stage of CKD?
Stage 3 (moderate kidney damage)
In ARF if GFR is less than 10 and patient isn’t catabolic or on CRRT (continuous renal replacement therapy) how much protein should they get?
0.8 g/kg/day
How much protein should an individual on hemodialysis have?
1.2 gm/kg/day
How much protein should an individual on peritoneal dialysis get?
1.2 to 1.3 gm/kg/day
What is the only completely accurate know the calories for a patient?
Indirect calorimetry
In ARF what is the standard k cals/ day for the person.
35 kcals/ kg
When might you have to replace Na in an ARF patient?
During recovery phase
How much protein for CKD stages 1-3?
0.75 gm/kg/day
For stages 4-5 of CKD how much protein?
0.6 gm/kg/day
What type protein should be encouraged for individuals with CKD?
High Biological Value (HBV)
eggs, meats, animal proteins
How much sodium is recommended for individuals with CKD?
<2.4 gms/day
When might a Potassium restriction be needed in individuals with CKD?
Later stages
If levels are >5 mEq/L
If a restriction of Potassium is for someone with CKD, what should that restriction be?
2-3 gm/day
When is a PO4 restriction needed in Stage 3 and 4 CKD?
If levels is >4.6
What do you restrict PO4 to if needed?
800-1000 mg/day
What condition does a PO4 restriction help prevent?
Secondary hyperparathyroidism
How do you calculate corrected calcium?
[(normal albumin (4.0)- serum albumin) (correction factor (0.8) + serum calcium
And increased urinary oxalate concentration leads to an increased risk of what?
Stones
For kidney stones, what is the urine output goal?
2L/ day
What fluid intake should be encouraged for individuals with kidney stones?
2.5-3 L
What should a patient with kidney stones not consume?
Grapefruit juice, apple juice
Calcium supplements
A low dietary calcium intake leads to an increased risk of what?
Oxalate absorption and excretion
What supplementation should those with kidney stones avoid?
Calcium Vitamin C (breaks down to oxalic acid and is excreted by kidneys)
What levels do you want to keep calcium between to limit tissue calcifications?
8.4-9.5
For nephrotic syndrome how much protein should an individual consume?
0.8-1 gm/kg/day
In the presence of edema with nephrotic syndrome, what should sodium be limited to?
2 grams/day in the presence of edema
What are some examples of foods high in K?
Bananas, beans, milk, chocolate, apricots, potatoes, honeydew, tomatoes, cantaloupe, avocado
What are some foods high in phosphorus?
cheese, red meat, potatoes
Why are CKD pts at increased risk of secondary hyperparathyroidism?
Not enough vitamin D –> calcium removed from circulation and excess PTH –> hypocalcemia
What are iron goals for Dialysis pt?
Iron sat >20%; Ferritin >200 ng/dL
What are folic acid needs for CKD?
1 mg/day
What are pyridoxine needs for CKD?
5 mg/day
What are vitamin C needs for CKD?
60-100 mg/day
How much sodium does a person on HD need?
2-3gm/day
How much protein does PD need?
1.2-1.3 gm/kg/day
How much protein does HD need?
1.2 g/kg/day
How much fluids does HD need?
1000mL/day + urine output
How much potassium does HD need?
2-3gm/day to maintain levels at 3.5-5.5mEq/L
What are serum calcium levels for HD and PD?
8.4-9.5 mg/dL
What are phosphorus levels for HD and PD?
1000-1200mg/day
Is fluid restriction recommended for nephrotic syndrome?
Not recommended unless patient is hyponatremic
What is hypocalcemia associated with?
hyperalbuminemia
What conditions is increased urinary oxalate seen in?
Roux-en-Y bariatric surgery, ilium resection, Malabsorption of dietary fat
With kidney stones, with 2.5-3.5 L/ fluid intake, what should the urine output goal be?
2 L/day
