2023-11-02T02:53:32+03:00[Europe/Moscow] en true <p> eGFR &lt; 60ml/min <strong><u>OR</u></strong> abnormalities of kidney structure/ function for &gt;=3 months (albuminuria) </p>, <p>&gt;= 90; normal </p>, <p>60-89; mildly decreased</p>, <p>45-59; mild-moderate decrease</p>, <p>30-44; moderate-severe decrease</p>, <p>15-29; severely decreased</p>, <p>&lt; 15; kidney failure </p>, <p>&lt; 30 mg/g; normal-mild increase</p>, <p>30-300 mg/g; microalbuminuria</p>, <p>&gt; 300 mg/g; macroalbuminuria </p>, <p>ACR &gt;=30 mg/g</p>, <p>change to urine volume/composition, edema/weight gain, SOB, fatigue/weakness, confusion, N/V, loss of appetite, peripheral neuropathy</p>, <p>lifestyle, control BP, manage diabetes, control albuminuria </p>, <p>exercise &gt;=30 min a week x 5 days/week, weight loss, smoking cessation, limit alcohol</p>, <p>&lt; 2.3 g/day </p>, <p>&lt; 2 g/day </p>, <p>potassium; phosphorus </p>, <p>0.6-0.8 g/kg/day</p>, <p>&lt;130/80; &lt;120 </p>, <p>when albuminuria is present </p>, <p>&lt; 6.5-7%</p>, <p>metformin </p>, <p>GFR &lt;45ml/min; &lt;30ml/min </p>, <p>SGLT2 inhibitor </p>, <p>alternatively; add on</p>, <p>titrate to max tolerated dose</p>, <p>with or without diabetes; persistent albuminuria despite ACEi/ARB</p>, <p>lower end; especially if GFR &lt; 30ml/min </p>, <p>patient experiences: vomiting, diarrhea, volume depletion; risk of AKI</p> flashcards
CKD (Therapeutics)

CKD (Therapeutics)

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  • eGFR < 60ml/min OR abnormalities of kidney structure/ function for >=3 months (albuminuria)

    What are the requirements for diagnosing CKD? (2)

  • >= 90; normal

    G1=

  • 60-89; mildly decreased

    G2=

  • 45-59; mild-moderate decrease

    G3a =

  • 30-44; moderate-severe decrease

    G3b =

  • 15-29; severely decreased

    G4 =

  • < 15; kidney failure

    G5=

  • < 30 mg/g; normal-mild increase

    A1 uACR =

  • 30-300 mg/g; microalbuminuria

    A2 uACR =

  • > 300 mg/g; macroalbuminuria

    A3 uACR =

  • ACR >=30 mg/g

    Albuminuria =

  • change to urine volume/composition, edema/weight gain, SOB, fatigue/weakness, confusion, N/V, loss of appetite, peripheral neuropathy

    What are symptoms of CKD? (8)

  • lifestyle, control BP, manage diabetes, control albuminuria

    What are the strategies to prevent CKD progression? (4)

  • exercise >=30 min a week x 5 days/week, weight loss, smoking cessation, limit alcohol

    What are the lifestyle interventions? (4)

  • < 2.3 g/day

    What are the sodium restrictions for CKD 3-5?

  • < 2 g/day

    What are the sodium restrictions for CKD + HTN?

  • potassium; phosphorus

    What electrolytes should patients adjust to keep in normal range? (2)

  • 0.6-0.8 g/kg/day

    What are the protein restrictions for CKD?

  • <130/80; <120

    What are ACC/AHA BP goals?

    What are KDIGO BP goals?

  • when albuminuria is present

    When are ACEi or ARB's 1st line?

  • < 6.5-7%

    What is the target A1c?

  • metformin

    What is the 1st line agent for DM + CKD?

  • GFR <45ml/min; <30ml/min

    Metformin should be used with caution in patients with what GFR?

    When do we discontinue it?

  • SGLT2 inhibitor

    What medication do we use when GFR is >= 20ml/min?

  • alternatively; add on

    GLP-1 agonists are used ______ or ______ to an SGLT2 inhibitors.

  • titrate to max tolerated dose

    How do we dose ACEi/ARBs?

  • with or without diabetes; persistent albuminuria despite ACEi/ARB

    When do we give SGLT2 inhibitors? (2)

  • lower end; especially if GFR < 30ml/min

    Which dose do we start with for ACEi/ARB?

  • patient experiences: vomiting, diarrhea, volume depletion; risk of AKI

    When do we hold the dose of ACEi/ARBs? (3)