7. Chronic Kidney Disease - Sakrani

• Most patients with CKD secondary to DM or HTN will die because of?

  heart disease before progress to advance CKD
• CKD - African American - gene: apolipoprotein gene1 (APOL1)
• Pt with stable CKD have increase sodium and water content = extracellular fluid volume expansion (ECFV)

  • contribute to existing hypertension
• Pt with peripheral edema + HTN - tx

  • strict dietary salt restriction
  • thiazide (stage 1-2)
  • stage 3b - loop diuretics + metolazone (thiazide)
• Advance CKD - when is indication for dialysis?

  diuretic resistance with intractable edema + hypertension
• CKD - potassium homeostasis - hyperkalemia

  • occur in earlier stage due to
  • type 4 renal tubular acidosis
  • high potassium diet
  • medication that decrease K+ excretion
• What is the leading cause of morbidity and mortality in pts at every stage of CKD?

  heart failure
• What is diagnostic of pericarditis?

  chest pain with respiratory accentuation + friction rub
• What is absolute indication for urgent initiation of dialysis/intensification of dialysis?

  uremic pericarditis
• Anemia is seen in stage 3 CKD bc?

  insufficient production of erythropoietin
• Abnormal hemostasis in people with CKD can lead to?

  thromboembolism
• what is the main therapy of anemia in people with CKD?


  erythropoietin or recombinant human ESA

  • Target Hb concentration: 100 -115 g/L - give if lower