Exam 4- Chronic Kidney Disease Introduction Flashcards
(26 cards)
Define CKD?
3 or more months of function or structure abnormalities in the kidneys.
Differentiate between structure vs. function abnormalities?
Structure: albuminuria greater than or equal to 30
Function: Decreased GFR (below 60)
What are the 3 most common causes of CKD?
- Diabetes
- HTN
- autoimmune disease (glomerular nephritis)
Name the progression factors of CKD excluding the CAUSES of CKD.
- Albuminurea/Proteinuria
- dyslipidemia
- smoking
- obesity
- lead exposure
- illicit drug use
GFR Categories
G1: greater than or equal to 90 G2: 60-89 G3: 30-59 G4: 15-29 G5: BELOW 1
Name the example of the autoimmune disease mentioned in class?
glomerulus nephritis
How do we stage for CKD?
CGA
Cause
GFR Category
Alubuminuria Category
What it the preferred method for CKD staging?
CKD-EPI (CKD- Epidemiology Collaboration) equation however for the purposes of this class we will use GFR Cockcroft Gault Equation
Increased levels of albumin are seen in in which type of patients? (think cause)
HTN
Diabetes
glomerular disease
Name the albuminuria staging categories.
A1: less than 30
A2: 30 to 300
A3: greater than 300
As GFR decreases what happens to SCr?
It INCREASES
Decrease in GFR= INCREASE in SCr
What six factors can cause CKD Complications?
M2PACE
M- Metabolic acidosis M- Metabolic bone disease P- Pruritius, Malnutrition, uremic bleeding A- Anemia C- Cardiovascular Disease E- electrolyte + fluid disorders
When are symptoms present in CKD stages?
Stage 1- 2: ASYMPTOMATIC (silent killer)
Stages 3-4: minimal symptoms
Stage 5: MORE symptoms
What 6 signs of CKD are seen in stages 3 through 5?
CHEF- UG C-Cardiovascular/Pulmonary H- Hematologic E- Endocrine F- Fluid/electrolytes U- Uremic Symptoms G- Gastrointestinal
What Lab values should be monitored in CKD patients?
SCr (BUN) AER GFR K (potassium) Glucose Phosphate CO2 (carbonate)
What are the 2 goals of CKD therapy?
- SLOW the progression
- MINIMIZE/MANAGE associated complications
Progression modifying therapy:
GFR less than 30
+/- diabetic
No more than 0.8g/kg/day protein
Progression modifying therapy:
At Risk of CKD progression
No more than 1.2g/kg/day protein
Progression modifying therapy:
Fluid retention
Lower Na intake to less than 2 g/day
Progression modifying therapy:
Physical activity
Exercise 30 minutes 5 times/week
Progression modifying therapy:
Diabetes control
A1c ~ 7%
Progression modifying therapy:
HTN
JNC-8 Goal less than 140/90 treat with ACE/ ARB
Progression modifying therapy:
AER greater than or equal to 30.
Treat w/ ACE/ARB to decrease proteins
Progression modifying therapy:
Dyslipidemia
ACC/AHA guidelines
Statin treatment
