CKD

Question 1

CKD Stages

Answer 1

1. GFR>90
2. 60-89
3. 30-59
4. 15-29
5. less than 15

Question 2

Dialyzable substances

Answer 2

Salicylates
Lithium
Isopropyl Alcohol
Magnesium Laxatives
Ethylene Glycol

Question 3

For proteinuric CKD patients, first line therapy includes

Answer 3

ACE/ARBs
MRAs if proteinuria persists

Check crt 7-14 days after starting these. If rise in > 30% – may need dose reduction.

Question 4

Complications in CKD

Answer 4

Vasular/HTN/CHF/Afib

valvular stenosis
pericarditis
Osteitis fibrosa cystica
Anemia
Coagulopathy
Hypothyroidism

Question 5

Anemia in CKD becomes clinically significant in stages

Answer 5

3b-4

Question 6

Testing for anemia in CKD is making sure that the bone marrow can respond so test for

Answer 6

B12, thyroid function tests, reticulocyte count, iron stores

CKD is associated with high hepcidin

Question 7

Iron suppllimentation in CKD if ferritin is below 500 mg/ml and iron sat is less than

Answer 7

30%

Question 8

Possible side effects from starting epo stimulating agent

Answer 8

HTN,
acceleration of underlying malignancy

Question 9

Showing progression of CKD

Answer 9

treat underlying cause
blood pressure control
antiproteinuric agent (ACE/ARB/MRA/SGLT2/GLP1)

Question 10

Drugs that should be adjusted for GFR

Answer 10

Insulin/ Sulfonyureas

Metformin

Morphine metabolites

NSAIDs

PPIs