Renal Health Maintenance

Question 1

Symptoms of kidney ailments that are important to screen for in history?

Answer 1

hematuria, facial/peripheral edema, fatigue, pallor, prurititus, decreased appetite

Question 2

What tests should be included to evaluate renal health in patients over age 60?

Answer 2

GFR, Cr, UA, microalbumin

Question 3

First clinical sign of diabetic nephropathy

Answer 3

microalbuminuria

Question 4

T/F microalbuminuria is below detection by regular dipstick

Answer 4

true

Question 5

When should you start controlling phosphorus by dietary and phosphorus binder therapy?

Answer 5

either elevated serum phosphorus or elevated serum PTH

Question 6

Treatment for elevated Ph

Answer 6

oral vitamin D to target of 35-70 in stage 3 or 70-110 in stage 4. Restrict dietary intake to 600-800mg/day (limit meat/dairy)

Question 7

Overall management of renal osteodystrophy

Answer 7

Keep Ca 9.5-10.5 and Ph 4.5-5.5. Might need to remove some parathyroids.

Question 8

The effectiveness of ACE/ARB is decreased due to interaction with what other drugs?

Answer 8

NSAIDs

Question 9

What catagories of abx can be nephrotoxic?

Answer 9

PCN, cephalosporins, sulfonamides, fluorquinolones

Question 10

What does the GFR need to be to buy a nephrology referral

Answer 10

eGFR <60. Referral not required if 60-89 unless other problems present

Question 11

Nutritional problems associated with decreased GFR

Answer 11

insulin resistance, decreased lipoprotein lipase, osteodystrophy, loss of HCO3-

Question 12

Most important predictors of poor outcome in ESRD

Answer 12

increased age, CVD, DM, poor nutrition