1
Q
CKD Definition
A
- structural or functional kidney abnormalities for at least 3 months (most commonly persistent proteinuria) or eGFR < 60 mL/min
2
Q
CKD Stages
A
- Stage I: eGFR > 90 and persistent albuminuria
- Stage II: eGFR 60-89 and persistent albuminuria
- Stage III: eGFR 30-59
- Stage IV: eGFR 15-29
- Stage V: eGFR <15
3
Q
New onset CKD tests
A
- U/A, CBC, GBCL, ACR, A1C, lipids, abdo US
4
Q
CKD Tx
A
- Statin for LDL < 2 for all
- HTN, DM management, smoking cessation, stop NSAIDS, hydrate, r/o obstruction
- Monitor ACR
- target to <40
5
Q
CKD when to start dialysis
A
- eGFR up to 6 OK to hold off if not hyperkalemia non-uremic and asymptomatic, but generally < 15 start dialysis
6
Q
When to refer CKD
A
- Stage IV
- progressive decline eGFR
- AKI
- cannot get patient to target values
- ACR > 60 (>500mg/24h)
7
Q
By how much does Cr increase per day in the absence of renal function?
A
- 80-250 mmol/L per day
8
Q
Contrast-induced nephropathy protocol
A
- Merten Protocol
- 3 amps bicarb in 1 L D5W
- 3 mL/kg bolus
- image
- then 1 mL/kg/h x 6h
- 3 amps bicarb in 1 L D5W
- Hold Metformin for 48h
9
Q
Indications for Emergent Dialysis
A
- uncontrolled K+ of 6.5 or rising
- intractable fluid overload
- uremic pericarditis
- progressive uremic encephalopathy
- Na <115 or >165
- severe metabolic acidosis with AKI
- life threatening poisoning with Li, aspirin, methanol, ethylene glycol, theophylline
- bleeding dyscrasia from uremia
10
Q
Treatment of Rhabdo
A
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EM
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