Screening & Staging
Which two measurements are used to assess and classify CKD under KDIGO guidelines?
Estimated GFR (eGFR) and urine albumin-to-creatinine ratio (UACR).
Which antihypertensive medication classes are preferred for patients with CKD and clinically significant albuminuria when indicated?
ACE inhibitor or angiotensin receptor blocker (ARB
Reduced production of which hormone contributes to anemia in CKD?
Erythropoietin (EPO).
What HbA1c target range does KDIGO recommend individualizing for adults with diabetes and CKD who are not treated with dialysis?
Approximately 6.5% to <8.0% (around 7% is often reasonable)
*individualized by hypoglycemia risk, comorbidities and treatment burden
Which common OTC analgesic class should generally be avoided with CKD because it can cause kidney injury?
NSAIDs, such as ibuprofen and naproxen, especially with prolonged use.
A patient has persistent eGFR of 40 mL/min/1.73 m². What CKD G category is this?
G3b (eGFR 30–44 mL/min/1.73 m²).
According to KDIGO 2024, what systolic BP target is suggested for most adults with CKD and hypertension when tolerated, using standardized office measurement?
Systolic BP <120 mmHg when tolerated *individualize for frailty, orthostasis and other risks.
What common deficiency should be assessed and treated when evaluating CKD-associated anemia before considering an ESA?
Iron deficiency; assess iron status (e.g., ferritin and transferrin saturation).
What common genitourinary adverse effect should be discussed when starting an SGLT2 inhibitor?
Genital infection (e.g., vulvovaginal candidiasis or balanitis)
Why refer a patient with moderate-to-advanced CKD to a renal dietitian?
Individualized medical nutrition therapy: appropriate energy and protein, sodium management, and potassium/phosphorus modification only when indicated by labs and clinical status.
What UACR range defines moderately increased albuminuria (A2)?
30 to <300 mg/g (A3 begins at ≥300 mg/g).
Which two laboratory values should be checked within 2–4 weeks after starting or increasing an ACE inhibitor or ARB?
Serum creatinine and potassium.
A patient with advanced CKD has elevated PTH, hyperphosphatemia and hypocalcemia. What endocrine complication of CKD-MBD is suggested?
Secondary hyperparathyroidism. Interpret calcium, phosphate and PTH trends together.
At what eGFR must metformin generally be discontinued?
eGFR <30 mL/min/1.73 m² (also hold temporarily in selected acute illnesses/procedures).
A patient with stage 3b CKD has an eGFR of 38 mL/min/1.73 m² and a urine albumin-to-creatinine ratio (UACR) of 450 mg/g. Despite treatment with an ACE inhibitor, albuminuria remains elevated. What additional medication class should the nurse practitioner consider to slow CKD progression?
An SGLT2 inhibitor, such as empagliflozin or dapagliflozin, to reduce the risk of CKD progression and cardiovascular events.