Kidney Disease

Question 1

What is microalbuminuria

Answer 1

30-300 mg/gtoo small to show up in dipstickshows early damage to kidney - time to treat! Delay or stop progression of damage

Question 2

What is proteinuria?

Answer 2

300-1000mg of Albumindipstick will turn positiveProtein to Cr ratio will be 1-2

Question 3

What does 4+ proteinuria indicate?

Answer 3

nephrotic!

Question 4

What causes transient proteinuria?

Answer 4

exercise, fever, postural proteinuria, dehydration, cold exposure, stress

Question 5

Criteria for nephrotic syndrome

Answer 5

• Al/Cr range >4
• Edema
• Decreased serum albumin
• Reflexive hyperlipidemia

Question 6

What are the major classifications of nephrotic syndrome?

Answer 6

Diabetes, Lupus, Drugs, InfectionsHTN does not cause nephrotic syndrome

Question 7

Stages of CKD

Answer 7

• 1 – protein in urine, normal GFR >90
• 2 – protein in urine GFR 60-89
• 3a – GFR 45-59
• 3b – GFR 30-44
• 4 – GFR 15-29
• 5 – FGR
  must persist >3mo

Question 8

CKD and salt

Answer 8

for BP control, almost always need salt restriction: 2 g/day

Question 9

CKD and protein

Answer 9

Protein:

• St 1-2: no restriction
  St 3-4: restrict
• high protein also –> high salt, aci precursors, phosphates. Can lead to metabolic acidosis, hyperkalemia, hyperphospathemia, edema, HTN, uremic sx
  Recommended: 0.8 g protein/kg ofideal body weight(actual wt may be d/t edema or obesity)
  if uremic sx persist - 0.6g/kg/day

Question 10

CKD and caloric intake

Answer 10

St 3-4:

Question 11

Medication assessment for CKD patient should include

Answer 11

At every visit:

• Dosage adjustment based on level of kidney function;
• Detection of potentially adverse effects on kidney function or complications of chronic kidney disease;
• Detection of drug interactions;
• Therapeutic drug monitoring, if possible.
  (KDOQI)

Question 12

What is theClassification of Kidney Disease Outcome Quality Initiative?

Answer 12

through the NKFThis program providesevidence-based guidelines for all stages of chronic kidney disease (CKD) and related complications