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Clin 3 > Renal Disease Pt. 1 > Flashcards

Renal Disease Pt. 1 Flashcards

1
Q

What are some of the risk factors for renal disease?

A 
diabetes
HTN
autoimmune disease
UTIs
Previous renal diseases
History of renal diseases
neoplasia
age
low birth weight
reduction in kidney mass
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2
Q

What are the 3 causes of CKF?

A

diabetes
HTN
Other renal diseases

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3
Q

What are the early and later symptoms of CKF?

A

Early: asymptomatic
Later: fatigue, nausea, vomiting, anorexia, insomnia, itching

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4
Q

What are the 4 criteria for a uremic toxin to be approved?

A
  1. has to be identified
  2. has to be higher in uremia
  3. there must be symptoms associated with it
  4. must of been studied in vivo levels
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5
Q

What are the 4 CDK phases?

A
  1. decreased renal reserve
  2. chronic renal insufficiency
  3. renal failure
  4. ESRD
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6
Q

What are the 4 CKD complications?

A
  1. uremic syndrome
  2. anemia
  3. fluid imbalances
  4. electrolyte imbalances
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7
Q

What is the best way to determine how much salt a patient consumed?

A

24h urine collection

amount of Na x 23

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8
Q

What are the 4 types of treatments for CKD?

A
  1. dialysis
  2. transplant
  3. diet, meds, treatment of risk factors to preserve function
  4. conservative care
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9
Q

What are the 3 meds that are usually used to correct electrolyte imbalances?

A
  1. K supplements
  2. PO4 binders
  3. Ca supplements
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10
Q

What are 4 meds that are given to help with CKD?

A
  1. Antihypertensives
  2. EPO
  3. Iron supplements
  4. Inactive/active vit D
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11
Q

What is the classification of CKD?

A 
Normal: GFR > 60 no kidney damage
Stage 1: GFR > 90 with kidney damage
Stage 2: 60-89
Stage 3a: 45-59
Stage 3b: 30-44
Stage 4: 15-29
Stage 5: <15
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12
Q

What are the two things that determine the severity of the kidney disease?

A

protein vs kidney function

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13
Q

What is the eGFR to go on predialysis?

A

13-50ml/min/1.73m

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14
Q

What are the nutrition goals for predialysis?

A 
Low protein
Restricted phosphorus 
Restricted potassium
Restricted sodium
Adequate kilocalories
Healthy foods and eating habits
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15
Q

What is the most accurate measurements to check for protein losses?

A

ACR

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16
Q

What are 3 things to reduce the progression of diabetic nephropathy?

A
  1. optimal glycemic control
  2. Optimal BP control
  3. ACEi or ARB
17
Q

What are the main food sources of potassium?

A
  • preservatives in processed foods
  • fruits and vegetables
  • milk products
  • nuts, seeds, legumes, lentils
  • whole grains/high fiber grains
  • meats
18
Q

What is the most bioavailable source of phosphorus?

A

food additives (90-100%)

19
Q

What are the main food sources of phosphorus?

A
  • food additives
  • milk/soy products
  • milk alternative
  • nuts and seeds
  • legumes and lentils
  • whole grains
20
Q

What are the protein recommendations?

A

0.8g/kg
renal exchange = 6-8g protein
50% protein is HBV (divide total protein by two, then by 7 for the exchange)

21
Q

What are the sodium recommendations?

A

1500-2300mg

22
Q

What are some factors that complicate treatment of malnutrition?

A
  • hyperkalemia
  • fluid overload
  • hyperphosphatemia
  • hyperglycemia
  • dyslipidemia
  • past dietary restrictions
23
Q

What is tolvaptan used for?

A

Tolvaptan is a AVP-V2 receptor blocker however patient with a high solute load (Na and protein) can produce copious amounts of urine resulting in extreme thirst

24
Q

What is the low osmolar diet for and what is it?

A

The goal is to have a low osmolarity (280/kg) in order to suppress vasopressin

  • high fluid intake
  • sodium intake of 1500mg
  • protein intake 0.8 g/kg

Clin 3 (12 decks)

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