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CKD Flashcards

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1
Q

What is the priority concept in CKD?

A

Elimination (kidneys heavily affect blood vessels)

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2
Q

What does the acronym A WET BED stand for?

A

Acid-base, Water balance, Erythropoiesis, Toxin removal, BP control, Electrolytes, Vitamin D activation

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3
Q

What is the kidney’s role in acid-base balance?

A

Regulates H⁺ and bicarbonate levels

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4
Q

What is the kidney’s role in water balance?

A

Controls fluid volume and osmolality

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5
Q

What is erythropoiesis?

A

Kidney production of erythropoietin → stimulates RBC production

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6
Q

What toxins do kidneys remove?

A

Urea and creatinine

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7
Q

How do kidneys control blood pressure?

A

RAAS system (renin → vasoconstriction & fluid retention)

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8
Q

How do kidneys maintain electrolyte balance?

A

Regulating Na, K, Ca, phosphate

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9
Q

How do kidneys affect Vitamin D?

A

Convert Vitamin D into calcitriol for calcium absorption

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10
Q

What percentage of cardiac output goes to kidneys?

A

25–30%

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11
Q

Why are kidneys vulnerable to hypoperfusion?

A

They are highly vascular

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12
Q

What are the two major regions of the kidney?

A

Cortex and medulla

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13
Q

What is the nephron?

A

Functional unit of the kidney

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14
Q

What structures are in the nephron?

A

Bowman’s capsule, glomerulus, proximal tubule, loop of Henle, distal tubule, collecting duct

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15
Q

When do renal symptoms appear?

A

After >50% nephron loss

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16
Q

What is GFR?

A

Amount of blood filtered by glomeruli per minute

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17
Q

Normal GFR range?

A

90–125 mL/min

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18
Q

How is GFR estimated?

A

Serum creatinine

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19
Q

What is CKD?

A

Progressive, irreversible kidney damage (stages 1–5)

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20
Q

What is stage 5 CKD?

A

End-stage renal disease

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21
Q

Is CKD reversible?

A

No, unless transplant

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22
Q

What is the main pathophysiology of CKD?

A

Reduced GFR, nephron loss, hyperfiltration → scarring

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23
Q

Who is at high risk for CKD?

A

HTN, diabetes

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24
Q

Why do people with heart failure often develop CKD?

A

Reduced perfusion to kidneys

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25
Key health promotion for CKD prevention?
Diet, lifestyle, avoid NSAIDs
26
Important History cues in CKD?
Diabetes, HTN, weight gain (1 kg = 1 L fluid), family hx
27
What neurological symptoms occur in CKD?
Brain fog, slowed conduction, risk of cerebral edema
28
Cardiovascular symptoms in CKD?
HTN, heart failure, edema
29
Respiratory symptoms in CKD?
Pulmonary edema, shortness of breath
30
Hematologic symptoms in CKD?
Anemia, impaired platelets, bleeding risk
31
GI symptoms in CKD?
Nausea, anorexia, ammonia buildup, ulcers
32
Urinary symptoms in CKD?
Oliguria, proteinuria, hematuria
33
Integumentary symptoms in CKD?
Dry skin, yellow/grey color, bruising, hair thinning
34
Musculoskeletal symptoms?
Bone pain from low calcium
35
Reproductive symptoms?
Decreased libido, menstrual changes
36
Metabolic symptoms?
Acidosis, electrolyte imbalance
37
Psychosocial symptoms?
Stress, anxiety, depression
38
Labs to monitor in CKD?
Creatinine, BUN, Na, K, Ca, phosphate, bicarbonate, Hb, Hct, eGFR, urinalysis
39
What are major changes in CKD?
Acidosis, water retention, anemia, toxin buildup, BP dysregulation, electrolyte imbalances
40
Why is phosphorus high in CKD?
Kidneys cannot excrete it
41
Why is calcium low in CKD?
High phosphorus binds calcium + poor vitamin D activation
42
Why is potassium the most important electrolyte in CKD?
Life-threatening arrhythmias
43
Normal potassium range?
3.5–5.1 mmol/L
44
What is BUN?
Measurement of protein metabolism waste in blood
45
Does BUN rise or fall in CKD?
Rises as GFR decreases
46
Is BUN reliable for kidney function?
No (affected by hydration, protein intake, GI bleeding)
47
Normal BUN range?
3.6–7.1 mmol/L
48
What is creatinine?
Waste product of muscle metabolism, excreted by kidneys
49
Why is creatinine reliable?
Not reabsorbed and predictable production rate
50
Normal creatinine range?
65–95 μmol/L
51
Creatinine level in CKD?
>500 μmol/L
52
Electrolyte patterns in CKD?
K high, Na varies, phosphate high, calcium low
53
Top priority hypotheses in CKD?
Fluid overload, decreased cardiac function, electrolyte imbalance, weight loss, injury risk, psychosocial compromise
54
How to manage fluid volume?
Monitor I&O, daily weights, assess for overload, diuretics
55
Best indicator of fluid status?
Daily weights
56
How to improve cardiac function?
BP control, protect heart, antihypertensives, diuretics
57
Most common cause of death in CKD?
Hyperkalemia
58
Foods to avoid in high potassium?
Coffee, tea, Gatorade, Red Bull, alcohol, oranges
59
Treatments for high potassium?
Sodium bicarbonate, insulin, dialysis
60
Nutrition recommendations in CKD?
Protein <1.3 g/kg/day, sodium 1–3 g/day, potassium 60–70 mEq/day, phosphorus restriction
61
Why refer to a dietitian?
Determine specific nutrition needs
62
How to prevent injury in CKD?
Fall prevention, monitor for infection, avoid nephrotoxic drugs
63
What is the purpose of kidney replacement therapy?
Removes waste, excess water; restores electrolytes and acid-base balance
64
Hemodialysis frequency?
3 times/week, 4–5 hours
65
How does hemodialysis work?
Blood passes through semipermeable membrane externally
66
Peritoneal dialysis frequency?
Daily, 7 days/week
67
How does peritoneal dialysis work?
Fluid exchanges occur in the peritoneal cavity
68
Strengths of hemodialysis?
Fast, efficient, relieves symptoms
69
Limitations of hemodialysis?
Needles, fluid/food restrictions, travel to clinic
70
Strengths of peritoneal dialysis?
Fewer dietary restrictions, flexibility, home use
71
Limitations of peritoneal dialysis?
Permanent abdominal catheter, peritonitis risk
72
AV fistula care: what is prohibited?
No BP, IV, or blood draws on fistula arm
73
What signs must be reported with AV fistula?
Absence of bruit/thrill, redness, drainage, movement of catheter
74
What are expected outcomes in CKD?
Fluid/electrolyte balance, good nutrition, no access infection, coping strategies, slow complications
75
Case: what findings suggest peritonitis?
Cloudy, foul-smelling dialysis effluent
76
What additional concerning findings in case study?
High BUN, abdominal pain, tachycardia, low diastolic BP
77
What condition is likely in the case scenario?
Peritonitis or sepsis
78
Priority interventions for peritonitis?
Oxygen, IV antibiotics
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