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SU18: Internal med final > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

(44 cards)

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1
Q

chronic kidney disease

A

progressive loss of renal fxn persisting >3 months

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2
Q

causes of chronic kidney disease

A
  • diabetes
  • hypertension
  • chronic glomerulonephritis
  • polycystic kidney disease
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3
Q

what percent of chronic kidney disease is caused by diabetes?

A

37%

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4
Q

what percent of chronic kidney disease is caused by hypertension?

A

24%

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5
Q

pathophysiology of chronic kidney disease

A
  • progressive destruction/deterioration of nephrons

- hypertrophy of remaining nephrons to compensate

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6
Q

homeostasis is preserved until what percent of nephron destruction?

A

> 50%

*can go without symptoms until then

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7
Q

what is used to diagnose and monitor chronic kidney disease

A

glomerular filtration rate (GFR)

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8
Q

glomerular filtration

A

process by which kidneys filter blood to remove excess waste and fluid

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9
Q

glomerular filtration rate (GFR)

A

a calculation to determine how well the blood is filtered by the kidneys

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10
Q

what is the best measure of overall fxn of kidneys?

A

GFR

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11
Q

clinical presentation of early disease

A

asymptomatic

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12
Q

what leads to symptoms of chronic kidney disease?

A
  • nitrogenous waste builds up in blood

- kidneys perform fewer excretory, endocrine, and metabolic fxns

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13
Q

how many chronic kidney disease stages are there?

A

5

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14
Q

stage 1 of chronic kidney disease

A

normal kidney fxn

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15
Q

what percent of kidney fxn do pts in stage 1 have?

A

90-100%

*pts at high risk of developing chronic kidney disease and need testing

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16
Q

stage 2 chronic kidney disease

A

mild kidney fxn

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17
Q

what percent of kidney fxn do pts in stage 2 have?

A

60-89%

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18
Q

at what stage of CKD are pts symptomatic?

19
Q

stage 3 chronic kidney disease

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A

moderate kidney fxn

20
Q

what percent of kidney fxn do pts in stage 3 have?

21
Q

stage 4 chronic kidney disease

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A

severe kidney fxn

22
Q

what percent of kidney fxn do pts in stage 4 have?

23
Q

stage 5 chronic kidney disease

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A

kidney failure

24
Q

what percent of kidney fxn do pts in stage 5 have?

25
medical management of CKD pts
- conservative care - dialysis - kidney transplant
26
conservative care is a way to medically manage pts in which stage of CKD?
stages 1 & 2 (GFR>60)
27
what does conservative care consist of?
- decrease nitrogenous waste retention (modified diet to decrease protein intake) - control HTN, fluids, electrolyte imbalance by limiting fluid, sodium, potassium intake - correct/control diabetes, HTN, chronic HF, hyperparathyroidism
28
dialysis is for pts in what stage?
stage 5 but sometimes 4 | *GFR <30 decision made on case by case basis
29
dialysis
artificial blood filtration
30
pts with what GFR must be under dialysis?
<15%
31
percent of pts that do peritoneal dialysis (dialysis at home)
20%
32
what is the decision to start hemodialysis?
GFR + clinical presentation
33
how often is hemodialysis?
every 2-3 days, 3-4 hours per session
34
are pts sick in between sessions of dialysis?
no, pts live a normal life relatively
35
what percent of normal renal fxn does hemodialysis provide?
only 15%
36
what is the best day to txt pts for dental care?
day after dialysis
37
what is surgically created in the forearm of dialysis pts?
AV fistula/graft
38
what does the AV fistula/graft allow?
- good access | - good blood flow
39
can we use the AV fistula/graft to check BP?
NO, only for urologist to use
40
dental management of CKD pts that are conservatively managed
- no contraindications to routine dental care but consult physician - avoid/adjust dosage of nephrotoxic drugs and those excreted by kidneys if GFR <60
41
what are common dental drugs CKD pts should avoid?
- NSAIDS | - Tylenol
42
why is Tylenol nephrotoxic when the liver metabolizes it?
because kidney excretes it
43
dental management of CKD pts on hemodialysis
- physician consultation - dental txtment on day after dialysis - avoid nephrotoxic drugs and those metabolized by kidney - no BP cuff on AV shunt
44
is antibiotic prophylaxis indicated for CKD pts on hemodialysis?
no, will get out of system at next dialysis session

SU18: Internal med final (25 decks)

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