Chronic Renal Disease Flashcards Preview

CRRAB II - Medicine > Chronic Renal Disease > Flashcards

Flashcards in Chronic Renal Disease Deck (19)
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What is the #1 cause of chronic kidney disease in the world?

Diabetes

1

What infections predispose an individual to CKD?

HIV, Hep C

2

What is the definition of CKD?

Kidney damage or GFR < 60 ml/min for at LEAST THREE Months.

3

What defines "Kidney Damage"?

Pathological abnormality in blood or urine or kidney imaging

4

What is the second leading cause of CKD?

Hypertension

5

What are the five stages of CKD?

1. Kidney damage and normal GFR (>90%)
2. Kidney damage and mild GFR decrease (60-89%)
3. Moderate GFR decrease (30-59%)
4. Severe GFR decrease (15-29%)
5. Kidney failure (<15%)

6

What factors can affect creatinine levels in the blood?

Reduced with low muscle mass
Increased with high protein diet
Drugs

7

What molecular marker is a much better test for kidney function?

Cystatin-C

8

What is the Crockroft Gault formula?

CC= (140-(age x weight))/(72 x Scr)

9

What test is used for the most accurate measurement of CC?

Plasma clearance (invasive)

10

What are the steps of kidney disease treatment?

1. Treat anything acute! Can be reversed.
2. Prevent or slow progression of the disease
3. Treat complications of renal disfunction
4. Prepare and initiate kidney transplant

11

What are the three categories of TREATABLE acute kidney disease?

Pre-renal (decreased flow)
Renal (nephrotoxic drugs)
Post-renal (outflow obstruction)

12

What are key factors/medications in preventing CKD progression?

ACE Inhibitor
HTN treatment
Dietary protein restriction
Glycemic control
Lipid control

13

What complications of CKD oftentimes need to be treated?

Anemia
Hyperkalemia
Volume overload
Metabolic acidosis
Hyperphosphatemia
Hyperparathyroidism

14

What are some key complications of metabolic acidosis? How do you treat it?

Bone disease worsening
Uremic acidosis may lead to muscle breakdown and reduced albumin synthesis

Treat with bicarb

15

How do you treat hyperphosphatemia?

Dietary restriction
Phosphate binders

16

What do you use to treat hyperparathyroidism?

Vitamin D supplements

17

What is the main problem with most hyperparathyroid treatments?

Increase serum calcium and phosphate

18

What steps are key to treating hyperparathyroidism?

1. Treat hyperphosphatemia
2. Vitamin D analogs to treat secondary hyperparathyroidism
3. If 2 doesn't work, then calcimimetics
4. Treat Vitamin D deficiency with cholecalciferol or ergocalciferol