Renal

Question 1

GI symptoms of AKI

Answer 1

anorexia, N/V, altered taste acuity, gastroenteritis, peptic ulcers, ascites

Question 2

how does AKI impact glycemic control?

Answer 2

insulin resistance > hyperglycemia

Question 3

what impact does AKI have on electrolytes?

Answer 3

-dysnatremia
-hyperkalemia
-hyperphos
-hypocalcemia

Question 4

what acid base disorder can AKI cause?

Answer 4

metabolic acidosis

Question 5

how is metabolism impacted in AKI?

Answer 5

hypermetabolic and hypercatabolic

Question 6

what electrolytes does HD dialysate contain that can be adjusted as needed?

Answer 6

Ca, K, Na, bicarb

Question 7

which type of dialysis between PD and HD has least restrictive diet?

Answer 7

PD

Question 8

why can hypokalemia occur in PD patients?

Answer 8

most commercially available solutions do not contain K and PO K supplementation may be needed to prevent/treat hypokalemia

Question 9

how much protein can be lost each day via PD?

Answer 9

5-24 g/day

Question 10

estimated absorption rate of dextrose/kcals from CAPD vs CCPD

Answer 10

CAPD: 50-60%
CCPD: 60-70%

Question 11

CKD (non-dialysis) calorie and protein needs

Answer 11

25-35 kcal/kg
0.55-0.8 g/kg (1 g/kg in illness)

Question 12

PD and HD calorie/protein needs

Answer 12

30-35 kcal/kg (including dialysate kcals)
>/= 1.2 g/kg

Question 13

CRRT calorie and protein needs

Answer 13

30-35 kcal/kg
1.5-2.5 g/kg

Question 14

AKI calorie and protein needs

Answer 14

20-30 kcal/kg
0.8-1 g/kg (non catabolic AKI without dialysis)
1-1.5 g/kg (AKI on RRT)

Question 15

fluid restriction for anuric pt with AKI

Answer 15

1-1.2 L/day (reflects insensible losses)

Question 16

which components of RRT may provide additional kcals?

Answer 16

glucose (3.4 kcal/g), lactate (3.62 kcal/g), citrate (3 kcal/g)

Question 17

anuric definition

Answer 17

UOP <50 mL/day

Question 18

oliguric definition

Answer 18

UOP 50-500 mL/day

Question 19

micronutrients of concern in CRRT

Answer 19

zinc, selenium, copper, vitamin C, thiamine, folic acid, vitamin B6, carnitine

Question 20

does calcitriol production progressively increase or decrease as CKD progresses?

Answer 20

decreases

Question 21

PTH is secreted in response to…

Answer 21

low serum calcium

Question 22

why does acidosis occur in AKI and CKD?

Answer 22

because of loss of normal acid excretion or loss of bicarbonate
*can also lead to hyperkalemia

Question 23

vitamin C dose for adults receiving RRT

Answer 23

100 mg/day

Question 24

why is excess accumulation of trace elements that are normally excreted renally unlikely during kidney disease?

Answer 24

because losses also occur through GI tract

Question 25

which trace element levels should be monitored in pts requiring CRRT for >1-2 weeks?

Answer 25

zinc, selenium, copper (>2 weeks)

Question 26

iron supplementation in kidney disease is recommended if ferritin is...

Answer 26

<100 ng/mL

Question 27

calcitriol supplementation may be needed if ...

Answer 27

iPTH is elevated

Question 28

normal BUN range

Answer 28

8-23 mg/dL

Question 29

normal creatinine range

Answer 29

0.6-1.2 mg/dL