CKD Flashcards
Macroalbuminuria
Random urine albumin/creatinine ratio > 300mg/g
Microalbuminuria
Random urine albumin/creatinine ratio 30-300mg/g
Early markers of renal injury
Albuminuria
Stages of CKD
Stage 1: GFR >/= 90 Stage 2: GFR >/= 60 Stage 3a: GFR >/= 45 Stage 3b: GFR >/= 30 Stage 4: GFR >/= 15 Stage 5: GFR < 15
A1: Albuminuria < 30mg/g
A2: Albuminuria 30-300mg/g
A3: Albuminuria > 300mg/g
Peak GFR
3rd decade of life ~120ml/min
Annual GFR decline rate
1ml/min/yr
Gold standard for measurement of albuminuria
24-hour urine collection
Marker for the presence of microvascular disease
Microalbuminuria
Five most frequent causes of CKD
- DM nephropathy
- Glomerulonephritis
- Hypertension-associated CKD
- Autosomal dominant polycystic kidney disease
- Tubulointerstitial nephropathy
Most frequent cause of CKD in Western countries
DM nephropathy
Electrolyte imbalance not commonly seen in CKD
Hyponatremia and hypokalemia
When to consider alkali supplementation
Serum HCO3 < 20mmol/l
Osteitis fibrosa cystica
Classic lesion of hyperparathyroidism which results from high-turnover bone disease in CKD (secondary hyperparathyroidism)
“Brown tumor”
What maintains normal serum phosphorus
FGF-23
Independent risk factor for LVH and mortality in CKD, HD, and transplant patients
High level of FGF-23
Manifestations, pathology and risk factor for calciphylaxis (calcific uremic arteriolopathy)
Manifests as livedo reticularis
Occurs due to vascular occlusion and calcification
Risk factor is warfarin use
Goal PTH level
150-300 pg/ml
Leading cause of mortality and morbidity in every stage of CKD
Cardiovascular disease
Low levels of what leads to more rapid vascular calcification especially with hyperphosphatemia
Fetuin
What stage of CKD is anemia seen
As early as stage 3, universal at stage 4
BP goal in CKD with DM or proteinuria > 1 g/24h
130/80
Goal hemoglobin level with EPO
10-11.5 mg/dl
Preferred anticoagulant in CKD
Conventional unfractionated heparin
What stage of CKD is uremic neuromuscular disease seen
Stage 3
