Nephrology Flashcards
(25 cards)
what numbers diagnose AKI
rise of SCr by 26.5 within 48hrs or 1.5x baseline within 7 days
urine volume <0.5mL/kg/h for 6 hours
what is oliguria? what is anuria
oliguria <400ml urine/ d
anuria <100ml urine/ d
T or F: eGFR is reliable to diagnose AKI
F- eGFR not accurate in AKI
instead of using IBW in obese pts, ______ should be used. If the pt is <IBW, then use ________
obese = adjBW
<IBW = use ABW
how to prevent contrast induced AKI
pre and post op prophylaxis IV fluids
how to prevent perioperative AKI
hold RAAS antagonists
volume reduction/ prevention of hypotension
how to prevent AKI from cancer chemo and tumor lysis
hydration w/ IV fluids and allopurinol qd for a few days before chemo to prevent uric acid nephropathy
what is considered severe hyperkalemia? what should be the first step to monitor?
K >6.5
cardiac monitoring for ECG changes (if yes -= start Calcium gluconate)
what does calcium gluconate do in hyperkalemia
membrane stabilization in ECG changes
what should you do in hyperkalemia if there are no ECG changes
salbutamol or insulin + dextrose IV
(both if severe >6.5)
then sodium bicarb IV if acidosis
which agents shift K+ into cells
sodium bicarb, insulin, salbutamol
how does sodium polystyrene work in hyperkalemia
eliminates K with sorbitol
CKD is the progressive replacement of normal kidney structure with
interstitial fibrosis
what are the numbers for dx of CKD
3 mths
CFR <60 or ACR >3mg/mmol
presence of markers of kidney damage with =>3 mths w/ or without decrease in GFR
what is 1st line tx for BG control in CKD
metformin, SGLT2
metformin should be avoided if CrCL is <
30
what is 1st and 2nd line tx for BP control in CKD? what is the target?
1st = ACEi/ARB
2nd = DHP-CCB or diuretic
target 120
what are the 3 CKD complications
hyperphosphatemia
secondary hyperparathyroidism
anemia + iron def
waht is 1st line tx for hyperphosphatemia? what if the person had hypercalcemia as well?
calcium carbonate
hypercalcemia = noncalcium binders (sevelamer, lanthanum, sucroferric oxyhydroxide)
what is the tx for secondary hyperparathyroidism
vit D analoges (alfacalcidol, calcitriol)
calcium mimetics (cinacalcet)
T or F: cinacalcet has to be taken with food
T to improve bioavailability
when should ESAs be started in CKD? what is the target?
if Hb 90-100
target 110
what should be started before ESAs in CKD
iron to boost stores
what is the earliest responding lab value to iron tx
reticulocyte count
