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What does KDOQI stand for?
Kidney Disease Outcomes Quality Initiative
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What does KDIGO stand for?
Kidney Disease Improving Global Outcomes
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What is a decreased GFR?
<60 ml/min/1.73m2
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What puts a person at “Increased risk” but not a specific stage of CKD?
≥ 60 (normal), with CKD risk factors, but without markers of damage
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Describe KDOQI Stage 1 of kidney failure:
- Kidney damage with normal or á GFR
- GFR: ≥ 90
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Describe KDOQI Stage 2 of kidney failure:
- Kidney damage with mild decreased GFR
- GFR: 60-89
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Describe KDOQI Stage 3 of kidney failure:
- Moderate decreased GFR
- GFR: 30-59
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Describe KDOQI Stage 4 of kidney failure:
- Severe decreased GFR
- GFR: 15-29
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Describe KDOQI Stage 5 of kidney failure:
- Kidney failure, ESRD
- GFR: <15 or dialysis
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What are the stages for KDIGO?
G1, G2, G3a, G3b, G4, G5
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What is a KDIGO G1:
- Normal or increased GFR
- GFR: ≥ 90
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What is a KDIGO G2:
Mildly decreased GFR GFR: 60-89
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What is a KDIGO G3a:
- Mildly to moderate decreased GFR
- GFR: 45-59
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What is a KDIGO G3b:
- Moderate to severely decreased GFR
- GFR: 30-44
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What is a KDIGO G4:
- Severely decreased GFR
- GFR: 15-29
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What are the 4 main disease associated with CKD?
- Diabetes mellitus
- Hypertension
- Glomerulonephritis
- Polycystic kidney disease
- (top two the most)
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What is KDOQIs cutoff for proneinuria?
>200 mg/g
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What is KDOQIs cutoff for microalbuminuria?
- >30 mg/g
- (also says: Women = 25-355 and men 17-250)
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What concentration of protein in the urine constitutes a Negative test result for a spot urine dipstick?
10 mg/dL
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What concentration of protein in the urine constitutes a Trace test result for a spot urine dipstick?
10-20 mg/dL
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What concentration of protein in the urine constitutes a 1+ test result for a spot urine dipstick?
30 mg/dL
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What concentration of protein in the urine constitutes a 2+ test result for a spot urine dipstick?
100 mg/dL
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What concentration of protein in the urine constitutes a 3+ test result for a spot urine dipstick?
300 mg/dL
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What concentration of protein in the urine constitutes a 4+ test result for a spot urine dipstick?
>1000 mg/dL
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What is ADAs cutoff for proneinuria (macroalbuminuria)?
>300 mg/g
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What is ADAs cutoff for microalbuminuria?
>30 mg/g
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According to KDOQI , a Diabetic, Normotensive, Normoalbuminuric patient should receive what level of primary preventative care to avoid neuropathy?
- NO ACEI or ARB
- Primary Prevention stratagies
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According to KDOQI , a Diabetic, Normotensive, Micro/Macro-albuminuric patient should receive what level of primary preventative care to avoid neuropathy?
ACEI or ARB
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According to KDOQI , a Diabetic, Hypertensive, Micro/Macro-albuminuric patient should receive what level of primary preventative care to avoid neuropathy?
ACEI or ARB
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What are the primary prevention strategies for proneinuria?
- Protein restriction = 0.6 g/kg/day
- Smoking cessation
- Weight loss
- HTN control
- Glycemic control
- Anemia treatment
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What is the JNC 8 goal BP for CKD?
Less than 140/90
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When should you add an ACEI or ARB in CKD according to JNC-8 and then what is the goal?
- HTN is greater than or equal to 140/90
- Titrate to goal of < 140/90
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What is the MOA of ACEIs and ARBs in preventing Diabetic neuropathy?
- Decrease efferent arteriolar tone
- Reduce pressure in the glomerulus
- Renoprotective
- + decreases proteinuria
- Reduce doubling SCr
- Reduceprogression to ESRD
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