Week 3 CKD Flashcards
What is the definition of CKD
The progressive irreversible loss of kidney function resulting in a GFR less than 60 mL/min/1.73 m2 for 3 months or longer
what is the definition of end stage renal disease
GFR less thatn 15 mL/min/1.73 m2
What is uremia
A collection of signs and symptoms that result from a buildup of urea and other waste products and excess fluid as a result of kidney failure
what is the definition of anuria
urine output less than 40 mL/24 hrs
what happens to the osmolality of urine during CKD
it starts to become about the same as plasma since the kidneys can no longer concentrate the urine
What is the best overall measure of kidney function eGFR, Creatinine or bun
eGFR is the best overall measure of kidney function
what hematological effects does PTH have
-Inhibit RBC production
-Shorten lifespan of RBC
-decrease number of hematopoietic cells (because it breaks down bone where these cells live)
What cardiac abnormalities can CKD cause
-Hypertension (most common one)
-Dysrhythmias (electrolyte imbalances)
-Uremic pericarditis (swelling of the sac around the heart)
what might a person’s respirations look like if they have very advanced CKD with metabolic acidosis
might have kussmaul respirations (Rapid deep breathing)
what are some integumentary changes that can occur from CKD
Pruritus
Uremic frost
what is uremic frost
When BUN levels are extremely high and urea begins to crystallize on the skin
What is one of the earliest and most important markers for kidney damage
Proteinuria
how is proteinuria measured
urine protein to creatinine ratio or albumin to creatinine ratio
what can ultrasound determine in CKD diagnoses
-Size of the kidneys
-Rule out obstruction
what can protect the myocardium from the toxic effects of hyperkalemia?
Calcium gluconate since it counteracts the effect of hyperkalemia on the myocardium
What medications can shift potassium back into cells
-IV regular insulin
-Salbutamol
-Sodium bicarbonate
What medications can promote potassium excretion
-Sodium polystyrene sulfonate (Kayexalate)
-Sodium zirconium cyclosilicate
-Patiromer
-Loop diuretics
what are two examples of phosphate binders
-Calcium carbonate
-Calcium acetate
What happens to calcium levels in a patient that has CKD
-Vit D must be activated by the kidneys (so when there not working its not activated)
-Vit D responsible for absorption of calcium so not working no calcium absorption=hypocalcemia
what would be one medication to treat anemia in a patient with CKD
Erythropoiesis-stimulating agent
what are two adverse effects that could result from taking erythropoiesis stimulating agents
-hypertension
-Iron deficiency (from the increased demand for iron to support formation of new RBC)
what medications is it important to establish baseline kidney function before taking them in CKD patients
-Digoxin
-Oral glycemic agents
-antibiotics
-opioids
Why are NSAIDS bad for the kidneys
-The can block a chemical that promotes renal vasodilation
(Causing the kidneys not to be perfused properly)
what foods are high in potassium
-Some fruits
-Some veggies
-beans
-legumes
What foods are high in phosphate
Dairy products and foods containing dairy
what are often the first signs of CKD
-hypertension
-changes in urine characteristics
