Knowledge
What is the expected range of serum creatinine?
0.5-1.2 mg/dL
Swelling, especially in the ankles, feet, legs, can occur in CKD due to fluid retention. This is known as:
Edema
This treatment option for advanced kidney failure involves the use of a machine to filter waste and excess fluid from the blood.
Dialysis
Managing this metabolic disorder is key to preventing kidney damage, as uncontrolled blood sugar levels can lead to kidney disease.
Diabetes, Uncontrolled diabetes can damage blood vessels in the kidneys over time, leading to diabetic nephropathy, a common cause of CKD. Proper blood sugar control is essential for preventing kidney damage.
A 72-year-old male with a history of diabetes and hypertension presents with fatigue, confusion, and nausea. He has been feeling progressively worse over the last few weeks. His lab results reveal a serum creatinine of 7.5 mg/dL, BUN of 85 mg/dL, GFR <15 mL/min, and significant hyperkalemia (6.5 mEq/L). A urinalysis shows minimal proteinuria.
What stage of CKD does this patient likely have, and what does this indicate for his treatment options?
With a GFR <15 mL/min, the patient is in Stage 5 CKD ESRD, which requires renal replacement therapy (dialysis or kidney transplant).
Which stage is known as the end-stage kidney disease?
Stage 5
When kidney function declines, this often occurs, leading to decreased of RBCs.
Anemia
This type of dialysis involves a tube placed into the abdominal cavity to allow for waste exchange.
Peritoneal Dialysis, is a type of dialysis where the lining of the abdominal cavity (peritoneum) acts as a natural filter. A tube is inserted into the abdomen to introduce and remove dialysis fluid, allowing waste products to be filtered from the blood.
Avoiding the excessive use of these over-the-counter medications can help prevent kidney damage.
NSAIDs, such as ibuprofen and naproxen, can reduce kidney function if taken excessively, as they can impair blood flow to the kidneys. Limiting their use helps protect kidney health.
A 72-year-old male with a history of diabetes and hypertension presents with fatigue, confusion, and nausea. He has been feeling progressively worse over the last few weeks. His lab results reveal a serum creatinine of 7.5 mg/dL, BUN of 85 mg/dL, GFR <15 mL/min, and significant hyperkalemia (6.5 mEq/L). A urinalysis shows minimal proteinuria.
What are the most concerning lab abnormalities in this patient, and how should they be managed immediately?
Hyperkalemia (calcium gluconate, potassium binders- sevelamer), Elevated BUN and creatinine- dialysis)
The kidneys produce this hormone, which stimulates red blood cell production in the bone marrow.
Erythropoietin
This electrolyte imbalance, common in patients with CKD, can cause dangerous heart arrhythmias.
Hyperkalemia
This treatment used to lower elevated serum potassium levels that allow excretion in the stool.
Kayexalate
Maintaining a healthy weight, reducing salt intake, and regular physical activity can help prevent this common condition that is a major risk factor for CKD.
Hypertension, Maintaining a healthy lifestyle can prevent high blood pressure, a key risk factor for CKD. Regular exercise, reducing salt intake, and managing weight are essential strategies for blood pressure control.
A 72-year-old male with a history of diabetes and hypertension presents with fatigue, confusion, and nausea. He has been feeling progressively worse over the last few weeks. His lab results reveal a serum creatinine of 7.5 mg/dL, BUN of 85 mg/dL, GFR <15 mL/min, and significant hyperkalemia (6.5 mEq/L). A urinalysis shows minimal proteinuria.
Given his worsening condition, what are the options for renal replacement therapy (RRT)?
Hemodialysis or peritoneal dialysis are the two primary modalities of RRT for patients in end-stage CKD. The patient’s age, overall health, and preference would guide the choice of dialysis method
What is the GFR for ESRD?
GFR <15
This occurs when the kidneys are unable to excrete enough waste, leading to a buildup of waste products in the bloodstream. It can cause nausea, vomiting, and confusion.
Uremia
This mineral, which is important for bone health, may need to be supplemented or monitored in CKD patient due to kidneys' reduced ability to activate it.
Calcium, in CKD, the kidneys’ reduced ability to convert vitamin D into its active form can impair calcium absorption, leading to low calcium levels. As a result, calcium supplementation may be necessary to prevent bone disease and fractures in CKD patients.
Preventing this type of infection, particularly in people with pre-existing kidney conditions, is important for kidney health.
UTIs, Frequent or untreated UTIs can lead to kidney infections (pyelonephritis), which may result in permanent kidney damage if not properly treated. Preventive measures, such as staying hydrated, proper hygiene, and timely treatment of UTIs, are important for kidney health.
A 72-year-old male with a history of diabetes and hypertension presents with fatigue, confusion, and nausea. He has been feeling progressively worse over the last few weeks. His lab results reveal a serum creatinine of 7.5 mg/dL, BUN of 85 mg/dL, GFR <15 mL/min, and significant hyperkalemia (6.5 mEq/L). A urinalysis shows minimal proteinuria.
What dietary recommendations are essential at this stage of CKD to prevent further complications? Select all the apply
-Increase protein intake
-Reduce sodium and potassium intake
-Restrict phosphorus intake
-Increase fluid intake