renal disease Flashcards
BUN to SCR 20:1 meaning
dehydration AKI
where does SGLT2 act in the glomerulus
In the proximal tubule 65% of NAgets reabsorbed here
where does Thiazide diuretics work
in the distal convulated tubule
where does K spairn diuretics work
collecting duct
drugs that are nephrotoxic
aminoglycosides
amp B
Cisplatin
cyclosporine
loop diuretics
NSAIDS
polymyxins
dye
tacrolimus
vancomycin
what does albumin it body represent in staging renal disease
albumin in urea >30 represents CKD
EGR <60 represents CKD
1st line for HPT
HPT with DIbaetes
Ace or ARB in CKD with albuminuria
if baseline Scr jumps >30% DC the ace/arb
+diabetes
- ACE/ARB
- SGLT2
what drugs require changes due to renal function
aminoglycosides, beta lactams, fluconazole, quinolones, vanc
LMWH, Rivoroxaban, apixaban, dabigatran
H2RAs, metoclopramide
bisphos, lithium
Cr< 60 avoid
nitrofurantoin
CrCL <50 avoid
tenofovir
voriconazole
CrCL < 30 avoid
TAF
NSAIDS
dabigatran, rivoroxaban
CRcL< 30 avoid
SGLT2
metformin
what minerals disorders in people with CKD
hyperphosphatemia- elevated PTH and phosphorus (phosphate binders before meals)
vitamin D deficiency
Iron deficiency
hyperkalemia
metabolic acidosis
what are some ways to prevent hyperphosphatemia
aluminum hydroxide (TID with meals
Calcium based- 1st line, acetate carbonate, TID with meals can cause hyper calcemia
aluminum free/ calcium free- $$$ ferric citrate, lanthanum carbonate, TID with meals
- Sevelamer carbonate- renvela TID with melas can also reduce ADEK also LDL 30%
how does PTC and phosphate or CKD
- kidney cant eliminate PHOS increases phos
- vit D cannot be activated also decrease calcium abosorption
- high phos low cal causes increase release of PTH
- PTH causes calcium apsorbtion but in CKD its not possible so Ca is pulled from bones causing fractures
- Low EPP levels cause anemia
