[PHARMA] CKD Flashcards
(41 cards)
stage 1 CKD
kidney damage w/ normal or increased GFR
<90
stage 5 CKD
kidney failure GFR <15 or dialysis indicated
aim of TTT
Delay the progression
Treat manifestations
prevent ARF
delaying the progression of CKD includes (6)
managing:
1-underlying cause
2-BP
3-Glycemic control
4-Proteinuria
5-Dyslipidemia
6-Subclinical hypothyroidism
Stage 1 CKD can be diagnosed by
US
CT
Proteinuria
preventing ARF includes
1-avoid dehydration
2-nephrotoxins
3-UTI
nephrotoxins include (6)
1-aminoglycosides
2-NSAIDs
3-IV contrast media
4- Amphotericin B
5-Cyclosporine
6-Tacrolimus
Discontinue ACEIs/ARBs
target BP
<140/90
which bp is more important to control
Systolic BP
if BP target is not reached then add
loop diuretics ± Non DHP CCBs, BBs, Vasodilators
administering anti-HTN TTT at bedtime leads to
decreased CVS risks
blood pressure control
ACEIs/ARBs, loop diuretics
if BP target not reached: loop diuretics ± , Non DHP CCBs, BBs, Vasodilators
BP control strategy
-ACEIs/ARBs
-measure Creatinine & K+ baseline levels before TTT
-monitor serum Creatinine, K+
-if BP target not reached: loop diuretics ± Non DHP CCBs, BBs, Vasodilators
discontinuing ACEIs/ARBs results in
return of renal function to baseline levels
glycemic control (7)
1-insulin
2-oral metformin
3-DPP4 inhibitors
4-Glipzide
5-Gliclazide
6-Repaglinide
7-Thiazoldindione
oral metformin elimination
renal
thiazoldindione eliminiation
hepatic
risk of using thiazoldindione
salt & water retention–> EDEMA
thiazoldindione CI in
CHF
why must oral metformin be avoided/ adjust its dose
renally eliminated–>risk of lactic acidosis
proteinuria control (3)
ACEIs/ARBs
Non DHP CCBs
Mineralocorticoid anatgonists
if creatinine levels >30% of baseline w/ ACEIS, ARBs
DISCONTINUE
all patients w/ proteinuria regardless of BP should receive
ACEIs/ARBs
risk of using mineralocorticoid antagonists
Hyperkalemia
