Chronic Kidney Disease

Question 1

Chronic renal failure is the same thing as ______ kidney disease.

Answer 1

Chronic

Question 2

Chronic kidney disease (CKD) is _________.

Answer 2

Progressive

Question 3

2 main risk factors for CKD:

Answer 3

Diabetes
Hypertension

Question 4

1/2 of CKD patients also have ______, due to uncontrolled glucose levels damaging the glomeruli.

Answer 4

Diabetes

Question 5

1 in ____ people with hypertension, will eventually develop CKD.

Answer 5

5

Question 6

Hypertension puts extra ________ on the vessels of the glomeruli, creating more resistance and damage.

Answer 6

Pressure

Question 7

Other risk factors of CKD:

Answer 7

Glomerulonephritis (rare)
Age
Family history
Ethnicity: African Americans and American Indians

Question 8

Prevention of CKD:

Answer 8

DASH diet
Mediterranean diet
Plant based diet
- Helps regulate blood pressure and sugar and also reduce acid load on kidneys

Question 9

GFR Calculation

Answer 9

Age
Race
Gender
Serum creatinine level

Question 10

T/F: Stages 1- 3 of kidney disease often have no symptoms.

Answer 10

True

Question 11

___________ in a basic metabolic panel will indicate GFR function. As it increases, GFR decreases.

Answer 11

Creatinine

Question 12

At stages 1-3, a __________ test will help detect CKD because as kidneys become damage, protein will leak into the urine.

Answer 12

Microalbumin

Question 13

_______ is the amount of albumin in the urine.

Answer 13

Albuminuria

Question 14

T/F: A microalbumin test will help detect early kidney disease due to the smaller amounts of albumin leaked in the urine.

Answer 14

True

Question 15

CKD is characterized by:

Answer 15

Proteinuria
Azotemia

Question 16

Proteinuria

Answer 16

Increased urine albumin

Question 17

Azotemia

Answer 17

Increased nitrogenous waste products - BUN and creatinine

Question 18

Serum albumin _____ and urine albumin ______ since we are leaking albumin from the blood, into the urine.

Answer 18

Decreases, increases

Question 19

Serum sodium levels ______ since CKD patients have fluid overload, diluting the sodium in the blood.

Answer 19

Decrease

Question 20

T/F: Serum sodium is a better indicator of fluid status, rather than sodium status.

Answer 20

True

Question 21

Fluid overload ____ serum sodium concentrations.

Answer 21

Dilutes

Question 22

Serum potassium and phosphorus _____ because the kidneys cant excrete these minerals in the urine.

Answer 22

Increases

Question 23

T/F: Potassium, phosphorus and sodium all highly affect fluid status.

Answer 23

F, only sodium

Question 24

Monitoring for CKD:

Answer 24

1. Fluid intake
   Intake > outputs (positive)
2. Edema
3. Weight is affected by fluid, ask for UBW or dry weight

Question 25

MNT for CKD (pre dialysis)

Answer 25

1. Higher energy needs to spare protein 35 kcals/kg IBW 2. Protein depends on GFR 0.6 - 1 g/kg 3. Sodium restriction 4. Potassium depends on urine output and serum levels 5. Phosphorus

Question 26

T/F: We want patients to use protein for energy, therefore increase protein

Answer 26

F, we want to decrease protein and consume adequate calories for fuel

Question 27

If GFR is less than 25, protein needs are:

Answer 27

0.6 - 0.8 g/kg

Question 28

If GFR is more than 25, protein needs are:

Answer 28

0.8 -1 g/kg

Question 29

The lower the GFR, the ____ protein the patient can consume.

Answer 29

Less

Question 30

Sodium restriction to lower BP, reduce fluid retention, and prevent excess urinary ______ excretion.

Answer 30

Protein

Question 31

Low urine output and high serum levels may warrant a potassium _________.

Answer 31

Restriction

Question 32

Potassium should only be limited if necessary, because ______ foods are protective against kidney disease.

Answer 32

Plant

Question 33

T/F: Phosphorus should be limited in CKD.

Answer 33

True and must be limited early on in the disease

Question 34

Phosphorous sources:

Answer 34

MFP Dairy Legumes Soda Processed foods high in phosphates Nuts and seeds Whole grains

Question 35

T/F: Phosphorus must be restricted to no more than 0.8-1.2 g/day

Answer 35

True

Question 36

T/F: Patients should limit phosphorous foods such as dairy and legumes as they are low biological value and consume MFP instead as they are high biological value.

Answer 36

True

Question 37

Since the mineral is widely found in food, patients can take _________ binders, which are a medication taken with meals that binds with phosphorus in food or the GI tract to prevent absorption.

Answer 37

Phosphate binders

Question 38

T/F: Patients taking phosphate binders can consume as much phosphorus containing foods that they want.

Answer 38

False, they must also limit phosphrous containing food

Question 39

Probiotics and _______ should be consumed since waste products wreak havoc on the gut but they also lower ammonia levels.

Answer 39

Prebiotics

Question 40

Types of phosphate binders:

Answer 40

Renvela Phoslo

Question 41

Stage 1 of CKD

Answer 41

"Normal GFR" 90 ml/min

Question 42

Stage 2 of CKD

Answer 42

Mild CKD 60 - 89 ml/min Time to ask the doctor for a microalbumin test to diagnose early kidney disease

Question 43

Stage 3 of CKD

Answer 43

Moderate CKD 30 - 59 ml/min

Question 44

Stage 4 of CKD

Answer 44

Severe CKD 15-29 ml/min Begin hemodialysis

Question 45

Stage 5 of CKD

Answer 45

End-stage/Kidney failure Less than 15 ml/min

Question 46

________ levels are measured in a basic metabolic panel.

Answer 46

Creatinine