Renal disease Flashcards
What is SCr impacted by?
age (muscle declines as we age)
sex (men have more muscle)
race
dietary intake
body compsution (athletes have more muscle)
medications
What does SCr represent?
metabolic byproduct of muscle catabolism
What medications can fasely increase SCr?
Cimetidine
Trimethoprim
Why is cystatin C better than other renal measurements?
Better with changing renal function/ varying protein status
What do we need to calculate CrCl?
- Stable SCr
- baseline value
- more than a single value
What is the Cockcroft gault equation?
(140-age) X kg / (SCr x 72) x 0.85 if female
What are limitation to cockcroft gault?
- assumes muscle mass declines linearly with age
- different for weight
When is IBW used?
actual weight > ideal
How do you calculate IBW?
Men: 50 + (2.3 x in> 5ft)
Women: 45.5 + (2.3 x in > 5ft)
When is AdjBW used?
actual body weight > 30% than ideal
How do you calculate AdjBW?
IBW + 0.4 x (actual- ideal)
Why is the MDRD equation not utilized often?
- less accurate when GFR >60 mL/ min/ 1.73 m2
- lacks data in extreme body weight, pregnancy, elderly
Why is the CKD-EPI equation not used often?
- less accurate when eGFR < 60 mL/min/1.73 m2
- too complex for clinical application
What measurement is best for patients >80
cystatin C
What drugs are usually dosed using IBW?
Acyclovir
Colistin
Digoxin
Levothyroxine
Lorazepam
IVIG
What drugs are usually dosed with AjdBW?
Amikacin
Gentamicin
Heparin
Tobramycin
What is chronic kidney disease?
GFR < 60 mL/min/1.73m2 due to damages endothelium and sclerosis leading to proteinuria
What can CKD lead to?
fluid, electrolyte, acid-base disorders