CMN 572 UNIT 4 CKD QUESTIONS
AND ANSWERS
Chronic Kidney Disease (CKD) - Correct Answers -Inability of kidneys to excrete
wastes; staged from 1 (mild damage to kidney) to 5 (complete kidney failure requiring
either dialysis or a renal transplant). Stage 5 is also called end stage renal disease
Essentials of diagnosis - Correct Answers -* decline in GFR over months to years
Persistent proteinuria or abnormal renal morphology may be present
* Hypertension in most cases
* symptoms and signs of uremia when nearing end-stage disease
* Bilateral small or echogenic kidneys on ultrasound in advanced disease
CKD risk factors - Correct Answers --AKI
-DM
-chronic glomerulonephritis
-nephrotoxic medications
-HTN
-autoimmune disorders
-polycystic kidney
-pyelonephrosis
-renal artery stenosis
-recurrent severe infections
Stages of CKD - Correct Answers --1,2,and 3: pt still functioning well, living fairly normal
life, may never progress or advance
-Stage 5: dialysis 3x/week
-Can't go on a week long vacation without dialysis; will end up back in the hospital
-Fistula = restricted extremity (no BP or IV)
Stages of CKD GFR - Correct Answers -1 GFR >/=90
2 GFR 60-89
3 GFR 30-59
4 GFR 15-29
5 GFR <15
CKD symptoms - Correct Answers -* asymptomatic in early stages
* symptoms do not manifest until disease is far advanced
Diagnostic Criteria for CKD - Correct Answers -GFR < 60, kidney damage > 3 months
, Abnormalities of kidney structure or function present for 3 or more months, with
implications for health
Either of the following must be present for >3 months:
- eGFR: <60 mL/min/1.73m2
- ACR: >30 mg/g
- Markers of kidney damage (one or more* ) Markers of kidney damage can include
urinalysis abnormalities such as glomerular hematuria, kidney biopsy abnormalities or
polycystic kidney disease on imaging studies.
CKD complications - start stage 3 - Correct Answers -Fluid overload, Water overload.
Acid Base Imbalance, Acidic Blood, Electrolyte Abnormalities.
Hypertension, Cardiac Disease, Vascular Disease.
Anemia/blood loss, Decrease production of red blood cells.
Bone Disease, Brittle bones and fractures.
Malnutrition.
CKD cardiovascular complications - Correct Answers -HTN
CAD
HF
Pericariditis
CKD vaccinations - Correct Answers -* Flu, unless contraindicated
* if Pneumonia GFR<30 or high risk
* Hep B if GFR <30
*Consider immune status if using live vaccine
CKD pneumonia vaccine - Correct Answers -o eGFR < 30 ml/min/1.73m2
o At high risk of pneumococcal infection (e.g., nephrotic syndrome, diabetes, receiving
immunosuppression), unless contraindicated
o Two vaccines PCV13 then PPSV23 12 months later; both should be offered
Malnutrition in CKD - Correct Answers -Malnutrition or protein energy wasting (PEW) is
common in CKD and is associated with poor patient outcomes.
• Malnutrition in CKD begins as early as stages 3 and 4. Risk increases with
progression of the disease.
• Preventing PEW or malnutrition may require clinical interventions to assess nutritional
status, individualize strategies for prevention and treatment, provide patient instruction,
and promote patient adherence.
• A specialty-trained registered dietician can help address the nutritional aspects so that
protein wasting can be diminished.
CKD and hypertension - Correct Answers -*most common complication
*focus on nonpharmacologic therapy and pharmacologic therapy
CKD hypertension - nonpharmacologic therapy - Correct Answers -Diet
exercise
AND ANSWERS
Chronic Kidney Disease (CKD) - Correct Answers -Inability of kidneys to excrete
wastes; staged from 1 (mild damage to kidney) to 5 (complete kidney failure requiring
either dialysis or a renal transplant). Stage 5 is also called end stage renal disease
Essentials of diagnosis - Correct Answers -* decline in GFR over months to years
Persistent proteinuria or abnormal renal morphology may be present
* Hypertension in most cases
* symptoms and signs of uremia when nearing end-stage disease
* Bilateral small or echogenic kidneys on ultrasound in advanced disease
CKD risk factors - Correct Answers --AKI
-DM
-chronic glomerulonephritis
-nephrotoxic medications
-HTN
-autoimmune disorders
-polycystic kidney
-pyelonephrosis
-renal artery stenosis
-recurrent severe infections
Stages of CKD - Correct Answers --1,2,and 3: pt still functioning well, living fairly normal
life, may never progress or advance
-Stage 5: dialysis 3x/week
-Can't go on a week long vacation without dialysis; will end up back in the hospital
-Fistula = restricted extremity (no BP or IV)
Stages of CKD GFR - Correct Answers -1 GFR >/=90
2 GFR 60-89
3 GFR 30-59
4 GFR 15-29
5 GFR <15
CKD symptoms - Correct Answers -* asymptomatic in early stages
* symptoms do not manifest until disease is far advanced
Diagnostic Criteria for CKD - Correct Answers -GFR < 60, kidney damage > 3 months
, Abnormalities of kidney structure or function present for 3 or more months, with
implications for health
Either of the following must be present for >3 months:
- eGFR: <60 mL/min/1.73m2
- ACR: >30 mg/g
- Markers of kidney damage (one or more* ) Markers of kidney damage can include
urinalysis abnormalities such as glomerular hematuria, kidney biopsy abnormalities or
polycystic kidney disease on imaging studies.
CKD complications - start stage 3 - Correct Answers -Fluid overload, Water overload.
Acid Base Imbalance, Acidic Blood, Electrolyte Abnormalities.
Hypertension, Cardiac Disease, Vascular Disease.
Anemia/blood loss, Decrease production of red blood cells.
Bone Disease, Brittle bones and fractures.
Malnutrition.
CKD cardiovascular complications - Correct Answers -HTN
CAD
HF
Pericariditis
CKD vaccinations - Correct Answers -* Flu, unless contraindicated
* if Pneumonia GFR<30 or high risk
* Hep B if GFR <30
*Consider immune status if using live vaccine
CKD pneumonia vaccine - Correct Answers -o eGFR < 30 ml/min/1.73m2
o At high risk of pneumococcal infection (e.g., nephrotic syndrome, diabetes, receiving
immunosuppression), unless contraindicated
o Two vaccines PCV13 then PPSV23 12 months later; both should be offered
Malnutrition in CKD - Correct Answers -Malnutrition or protein energy wasting (PEW) is
common in CKD and is associated with poor patient outcomes.
• Malnutrition in CKD begins as early as stages 3 and 4. Risk increases with
progression of the disease.
• Preventing PEW or malnutrition may require clinical interventions to assess nutritional
status, individualize strategies for prevention and treatment, provide patient instruction,
and promote patient adherence.
• A specialty-trained registered dietician can help address the nutritional aspects so that
protein wasting can be diminished.
CKD and hypertension - Correct Answers -*most common complication
*focus on nonpharmacologic therapy and pharmacologic therapy
CKD hypertension - nonpharmacologic therapy - Correct Answers -Diet
exercise
