Renal disease Flashcards
Which stages of kidney disease are symptomatic?
4 and 5
How do bad kidneys cause secondary hyperparathyroidism?
Bad kidneys can’t get calcium back out of filtrate in the PCT and they also can’t hydroxylate vitamin D so calcium levels remain low and PTH remains high.
What is the 5th stage of kidney disease?
Kidney failure. Transplant or dialysis needed
____% of cases of kidney failure are caused by diabetes. The three other major causes are: ______
50
Other causes: hypertension, glomerulonephritis, kidney stones.
What are the three main goals of treatment for kidney disease?
- Delay progression
- Treat complications
- Provide renal replacement therapy
What are the barriers to properly nourishing patients with chronic kidney disease?
Meds make eating unpalatable, delayed gastric emptying, inflammation and infection, multiple medications, metabolic acidosis, and social factors such as loneliness, depression, and poverty.
What types of nutritional changes are often applied to patients with CKD?
Limit protein to .6-.8 grams per kilogram body weight, limit sodium to 1-3g/day, limit phosphorus.
Why does kidney disease cause secondary hyperparathyroidism and how is it treated?
Kidney cannot convert 25-OH hydroxycholecalciferol to 1, 25-OH hydroxycholecalciferol so calcium is not absorbed in the GI tract. Can be treated by supplementing with 1,25 -OH vitamin D.
Why must phosphorus be restricted in patients with CKD? What foods are it found in?
Hyperphosphatemia develops when GFR drops to 25 mL/min or less. Found in high protein foods, cola, whole grains, dairy, nuts.
Why does anemia happen with CKD? How is this treated?
EPO is not made. So exogenous EPO is given.
How does acidosis occur in patients with CKD? How is it treated?
Acid is not excreted like normal. Bicarbonate is the treatment.
When is kidney replacement therapy like hemodialysis indicated?
When GFR drops below 15 ml/min. This is considered stage 5 CKD
What are the side effects of hemodialysis?
Protein losses of 6-8g per treatment. Nausea, vomiting, cardiovascular instability, fatigue.
What are the nutritional recommendations for patients on hemodialysis?
In addition to low phosphorus and low sodium the following is recommended: protein consumption (at least 1.2 g/kg) and fiber intake in the range of 25-30 g/day.
What are the risks of peritoneal dialysis?
Discomfort, peritonitis, malnutrition due to always feeling satiated, hyperglycemia due to glucose absorption through the peritoneum.
