EDAPT CHRONIC KIDNEY DISEASE OVERVIEW AND UPDATED CLINICAL GUIDELINES
COMPREHENSIVE EXAM
SECTION 1: CKD DEFINITION AND CLASSIFICATION
1. Which definition correctly characterizes chronic kidney disease according to the
KDIGO 2024 guideline?
A. Kidney damage or GFR < 60 mL/min/1.73 m² for > 3 months
B. Kidney damage or GFR < 90 mL/min/1.73 m² for > 1 month
C. Acute decline in kidney function lasting > 7 days
D. Irreversible kidney failure requiring dialysis
Answer: A
Rationale: CKD is defined as abnormalities of kidney structure or function present for >3
months, with implications for health. The threshold of GFR <60 mL/min/1.73 m² for >3
months is correct.
2. The CGA staging system for CKD includes which three components?
A. Creatinine, glucose, albumin
B. Cause, GFR category, albuminuria category
C. Calcium, glomerular function, acid-base status
D. Cardiovascular risk, GFR, age
Answer: B
Rationale: The CGA system stands for Cause, GFR category (G1-G5), and Albuminuria
category (A1-A3). This replaced the older GFR-only staging system.
,3. A patient has an eGFR of 45 mL/min/1.73 m² and a urine albumin-to-creatinine ratio
of 250 mg/g. What is the correct CKD classification?
A. G3a, A3
B. G3b, A2
C. G3a, A2
D. G4, A3
Answer: C
Rationale: eGFR 45-59 is G3a. uACR 30-300 mg/g is A2. The patient is classified as G3a,
A2.
4. Which GFR category represents severely decreased kidney function?
A. G3a
B. G3b
C. G4
D. G5
Answer: B
Rationale: G3b represents moderately to severely decreased GFR (30-44 mL/min/1.73 m²).
G4 is severely decreased (15-29), and G5 is kidney failure (<15).
SECTION 2: EVALUATION AND DIAGNOSTIC TESTING
5. According to KDIGO 2024, which equation is preferred for estimating GFR when
accuracy is critical for clinical decision-making?
A. Cockcroft-Gault equation
B. Creatinine-based eGFR alone
C. Creatinine and cystatin C combined equation
D. 24-hour urine creatinine clearance
Answer: C
Rationale: KDIGO 2024 recommends using eGFRcr-cys (combined creatinine and cystatin
C) in clinical situations when eGFRcr is less accurate and GFR affects clinical decision-
making .
6. Which test should be used in addition to eGFR to evaluate patients at risk for or with
CKD?
,A. Serum potassium
B. Urine albumin-to-creatinine ratio
C. Serum calcium
D. Hemoglobin
Answer: B
Rationale: KDIGO 2024 Practice Point 1.1.1.1 states that persons at risk for and with CKD
should be tested using both urine albumin measurement and assessment of GFR .
7. How often should uACR be evaluated in patients with CKD according to best
practice?
A. Once at diagnosis only
B. Annually for all patients
C. Once per year for low-risk, more frequently for high-risk
D. Only when proteinuria is clinically suspected
Answer: C
Rationale: uACR testing should be performed annually for lower-risk individuals, with more
frequent monitoring for those with higher risk based on GFR and albuminuria categories.
8. Which risk prediction tool is best studied and recommended for estimating kidney
failure risk in patients with CKD G3-G5?
A. Framingham Risk Score
B. Kidney Failure Risk Equation
C. MDRD equation
D. Cockcroft-Gault formula
Answer: B
Rationale: The Kidney Failure Risk Equation is the best studied validated risk equation for
predicting kidney failure in people with CKD .
9. A 5-year kidney failure risk of what percentage suggests the need for nephrology
referral?
A. 1-2%
B. 3-5%
C. 10-15%
D. >20%
, Answer: B
Rationale: KDIGO Practice Point 2.2.1 states that a 5-year kidney failure risk of 3%-5% can
be used to determine need for nephrology referral .
SECTION 3: COMPLICATIONS AND PATHOPHYSIOLOGY
10. A patient with advanced CKD develops fatigue and pallor. Laboratory studies show
hemoglobin of 9.2 g/dL. What is the most likely cause of anemia in this patient?
A. Iron deficiency from poor dietary intake
B. Decreased erythropoietin production
C. Hemolysis from uremic toxins
D. Folate deficiency
Answer: B
Rationale: Anemia in CKD is primarily due to decreased erythropoietin production by the
failing kidneys .
11. Which acid-base imbalance is most commonly associated with chronic kidney
disease?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: C
Rationale: CKD impairs kidney acid excretion and bicarbonate generation, leading to
metabolic acidosis as a characteristic imbalance .
12. A patient with CKD complains of pruritus and has crystallized white deposits on
the skin. What is the most likely cause?
A. Hypercalcemia
B. High urea levels
C. Hypernatremia
D. Hypophosphatemia
COMPREHENSIVE EXAM
SECTION 1: CKD DEFINITION AND CLASSIFICATION
1. Which definition correctly characterizes chronic kidney disease according to the
KDIGO 2024 guideline?
A. Kidney damage or GFR < 60 mL/min/1.73 m² for > 3 months
B. Kidney damage or GFR < 90 mL/min/1.73 m² for > 1 month
C. Acute decline in kidney function lasting > 7 days
D. Irreversible kidney failure requiring dialysis
Answer: A
Rationale: CKD is defined as abnormalities of kidney structure or function present for >3
months, with implications for health. The threshold of GFR <60 mL/min/1.73 m² for >3
months is correct.
2. The CGA staging system for CKD includes which three components?
A. Creatinine, glucose, albumin
B. Cause, GFR category, albuminuria category
C. Calcium, glomerular function, acid-base status
D. Cardiovascular risk, GFR, age
Answer: B
Rationale: The CGA system stands for Cause, GFR category (G1-G5), and Albuminuria
category (A1-A3). This replaced the older GFR-only staging system.
,3. A patient has an eGFR of 45 mL/min/1.73 m² and a urine albumin-to-creatinine ratio
of 250 mg/g. What is the correct CKD classification?
A. G3a, A3
B. G3b, A2
C. G3a, A2
D. G4, A3
Answer: C
Rationale: eGFR 45-59 is G3a. uACR 30-300 mg/g is A2. The patient is classified as G3a,
A2.
4. Which GFR category represents severely decreased kidney function?
A. G3a
B. G3b
C. G4
D. G5
Answer: B
Rationale: G3b represents moderately to severely decreased GFR (30-44 mL/min/1.73 m²).
G4 is severely decreased (15-29), and G5 is kidney failure (<15).
SECTION 2: EVALUATION AND DIAGNOSTIC TESTING
5. According to KDIGO 2024, which equation is preferred for estimating GFR when
accuracy is critical for clinical decision-making?
A. Cockcroft-Gault equation
B. Creatinine-based eGFR alone
C. Creatinine and cystatin C combined equation
D. 24-hour urine creatinine clearance
Answer: C
Rationale: KDIGO 2024 recommends using eGFRcr-cys (combined creatinine and cystatin
C) in clinical situations when eGFRcr is less accurate and GFR affects clinical decision-
making .
6. Which test should be used in addition to eGFR to evaluate patients at risk for or with
CKD?
,A. Serum potassium
B. Urine albumin-to-creatinine ratio
C. Serum calcium
D. Hemoglobin
Answer: B
Rationale: KDIGO 2024 Practice Point 1.1.1.1 states that persons at risk for and with CKD
should be tested using both urine albumin measurement and assessment of GFR .
7. How often should uACR be evaluated in patients with CKD according to best
practice?
A. Once at diagnosis only
B. Annually for all patients
C. Once per year for low-risk, more frequently for high-risk
D. Only when proteinuria is clinically suspected
Answer: C
Rationale: uACR testing should be performed annually for lower-risk individuals, with more
frequent monitoring for those with higher risk based on GFR and albuminuria categories.
8. Which risk prediction tool is best studied and recommended for estimating kidney
failure risk in patients with CKD G3-G5?
A. Framingham Risk Score
B. Kidney Failure Risk Equation
C. MDRD equation
D. Cockcroft-Gault formula
Answer: B
Rationale: The Kidney Failure Risk Equation is the best studied validated risk equation for
predicting kidney failure in people with CKD .
9. A 5-year kidney failure risk of what percentage suggests the need for nephrology
referral?
A. 1-2%
B. 3-5%
C. 10-15%
D. >20%
, Answer: B
Rationale: KDIGO Practice Point 2.2.1 states that a 5-year kidney failure risk of 3%-5% can
be used to determine need for nephrology referral .
SECTION 3: COMPLICATIONS AND PATHOPHYSIOLOGY
10. A patient with advanced CKD develops fatigue and pallor. Laboratory studies show
hemoglobin of 9.2 g/dL. What is the most likely cause of anemia in this patient?
A. Iron deficiency from poor dietary intake
B. Decreased erythropoietin production
C. Hemolysis from uremic toxins
D. Folate deficiency
Answer: B
Rationale: Anemia in CKD is primarily due to decreased erythropoietin production by the
failing kidneys .
11. Which acid-base imbalance is most commonly associated with chronic kidney
disease?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: C
Rationale: CKD impairs kidney acid excretion and bicarbonate generation, leading to
metabolic acidosis as a characteristic imbalance .
12. A patient with CKD complains of pruritus and has crystallized white deposits on
the skin. What is the most likely cause?
A. Hypercalcemia
B. High urea levels
C. Hypernatremia
D. Hypophosphatemia
