Unknowns

Question 1

CKD GFR Categories

Answer 1

Question 2

Finerenone

Answer 2

AE:
-hyperkalemia
-hypotension
-hyponatremia

DDI: CYP3A4 inh/ind

Question 3

-proteinuria
-primary immunoglobulin A nephropathy (IgAN)
-upcr ≥1.5 g/g

Answer 3

Use Sparsentan (Filspari)
-dc raas agents
-200 mg x 2 wk then 400 mg

CI in pregnancy

AE
-edema, hypotension, dizziness, hyperkalemia, anemia, hepatotoxicity (HHHEAD)

DDI: CHAP

REMS program for hepa/preg

Question 4

Anemia CKD

Answer 4

Erythropoietin-Stimulating Agents
-Epoetin and darba

BBW: cardiac, mortality, TE, tumor

Question 5

Normal PTH Value

Answer 5

15-65

Question 6

Vitamin D Analogs (calcitriol, doxercalciferol, paricalcitol)

Answer 6

CKD Stage 4-5 and PTH 65+ only

AE
-High Ca/Phos
-Bone disease

Question 7

Cinacalcet

Answer 7

PTH 65+ and CA 10.2+

AE: NV, hypocalcemia

DDI: 2D6

30-180 mg po daily w food

Question 8

Nephrotoxins

Answer 8

NSAIDs, herbals

Question 9

Normal Phos

Answer 9

2.5-4.5

Question 10

Bone Disease TX

Answer 10

1. Dietary phos control first (limit dairy, coke, nuts, beans, choc)
2. Sevelamer (chol/ldl lowering)
3. Lanthanum
4. Ca/Al

Question 11

Metabolic Acidosis in CKD

Answer 11

-Sodium Bicarbonate
650 mg tabs, 1-2 tabs to TID

-Bicitra Solution
30 ml daily to TIB

AE: GI

Question 12

CD TX

Answer 12

MILD
-SULFA
-ORAL CS
-BUDESONIDE
-AZA/MERCA/MTX

SEV
-IV CS
-BIO
-AZA/MERC/MTX
-JAKS

Question 13

UC TX

Answer 13

MILD
-5ASA
-BUDESONIDE
-ORAL CS

SEV
-5ASA, BUD, CS
-AZA/MTX
-BIO
-JAKS
-S1P

Question 14

Don’t use aminosalicylates (ASA)

Answer 14

If sulfa allergy

Question 15

Azathioprine/Mercaptopurine

Answer 15

AE: (PBSLNL)
-BMS, pancreatitis
-Lyphoma, hepa
-Nausea, skin cancer

Question 16

Anti-Integrin, Natalizumab

Answer 16

BBW: PML (mon for sx)

THROUGH REMS

CI: PML/hepatic/combo with CS and antiTNF

Question 17

Small Molecules: S1P Modulators
Ozanimod, Etrasimod

Answer 17

CI: CV issues in last 6 mo, Mobitz 2, (OZ: sleep apnea/MAOI?

AE: Brady, AVB, inf, PML, PRES, edema, resp effects, hepa, HTN, skin cancer

NOT in pregnancy