CKD

Question 1

T/F: Loss of Kidneys are more likely to cause acidity

Answer 1

True

Question 2

What enzymes are created by the kidney

Answer 2

Renin, erythropoietin, calcitriol

Question 3

What is the main determinant on what gets through a glomerular filtration barrier, what part of the glomerulus maintains integrity and selectivity

Answer 3

molecular size, podocyte

Question 4

T/F: The GFR is the product of the average filtration rate of single nephron multiplied by the number of nephrons in both kidneys

Answer 4

True

Question 5

What is GFR dependent on

Answer 5

body size, age, and physiologic state

Question 6

What can cause a decline GFR

Answer 6

decline in number of functioning nephrons or due to a single nephron

Question 7

What is normal GFR for females,males

Answer 7

120ml/min/1.73m2, 130ml/min/1.73m2

Question 8

T/F: CrCl is equal to the GFR

Answer 8

False: CrCl overestimates GFR by 15-20%

Question 9

What factors affect serum creatinine

Answer 9

Age, gender, race, diet, body weight, medications

Question 10

What equation is the most widely used equation but least accurate, state it

Answer 10

(140-age)ABW/(Scr X 72)

Question 11

What is an automatic diagnosis of CKD

Answer 11

GFR less than 60ml/min/1.73m2 for more than 3 months

Question 12

What are the three ways CKD can be defined

Answer 12

Cause, GFR category, Albuminuria

Question 13

What is the prevalent stage of CKD

Answer 13

Stage 3

Question 14

What is the number 1 reason to get CKD, number 2 reason

Answer 14

Diabetes, Hypertension

Question 15

T/F: Overusing NSAIDs can cause CKD

Answer 15

True

Question 16

What are less frequent causes of CKD

Answer 16

primary and secondary glomerular disease, hereditary disease, HIV, Transplantation

Question 17

T/F: Damage to the Glomerulus causes smaller aterioles leading to less filtration allowing larger molecules to flow through

Answer 17

False: Damage to Glomerulus allows causes large arterioles leading to more filitraion allowing larger molecules to flow through

Question 18

How does diabetes cause CKD hemodynamically

Answer 18

RAAS activation, increased vasoconstrion of efferent arteriole, increased glomerular hyperfiltration

Question 19

How does glomerular hyperfiltration contribute to CKD

Answer 19

podocytes are destroyed leading to albuminuria

Question 20

What constitutes as microalbuminuria, macroalbuminuria

Answer 20

30-300 mg/day, greater than 300 mg/day

Question 21

When assessing the protein/creatinine (P/C) ratio what ratio indicates damage

Answer 21

If the total P/C ratio is greater than 200mg/g

Question 22

T/F: ACE-1 and/or ARBs vasodilate the afferent arteriole to relieve glomerular HTN

Answer 22

False:ACE-1 and ARBs vasodilate the efferent arteriole to relieve glomerular HTN

Question 23

T/F: Even if a patient is normotensive they can recieve ACE-1 or ARBs because they are renoprotective

Answer 23

True

Question 24

What is an important counseling point if someone has proteinuria and is taking an ARB or ACE-1

Answer 24

Reduce Na intake

Question 25

How does hypertension lead to CKD

Answer 25

breakdown of elastic fibers in arterial circulation leading to an increase of pressure in the glomerulus and decreased glomerular bloodflow leading to glomerular HTN and hyperfiltration

Question 26

What are signs of CKD

Answer 26

Edema, Anemia. less urine, electrolytes in dissary

Question 27

What are the four signs of uremia

Answer 27

Diminished excretion of electrolytes and water, decreased excretion of organic solutes, decreased synthesis or renal hormones, maladaptive changes due to compensation

Question 28

What GFR is considered renal failure, what happens to Scr and BUN

Answer 28

GFR is 10-15 ml/min/1.73m2, both increase

Question 29

T/F: A diagnosis of CKD can made with high GFR

Answer 29

True

Question 30

What are the factors that affect the prognosis

Answer 30

cause of kidney disease, time of diagnosis, degree of albuminuria, presence of other comorbid conditions

Question 31

What are conditions when someone should see their nephrologist

Answer 31

GFR less than 30, albuminuria

Question 32

T/F: Cardiovascular complications are top reason for increased risk of death in dialysis patients

Answer 32

True