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40 Cards in this Set
- Front
- Back
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typically a pt with stage II renal disease will present with what abnormal lab values? 5
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elevated triglycericeds
high LDL high cholesterol low HDL elevated triglycerides |
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85 kg pt with stage III renal disease should consume what percent less protein than a normal 85kg person?
aka how many g/Kg of protein should a person w/ renal failure consume? |
.6g/Kg is suggested for ppl with renal failure
normal levels are .8g so you should have 25% less |
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a pt with stage IV renal disease is most likely to have a deficiency in which vitamin (the largest deficiency)
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has to do with PTH (which is elevated in kidney failure) so an in crease in PTH, you will have a vitamin D deficiency
30 picograms/mil is what you want it to be |
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a deficiency of vitamin D in this patient is primarily caused by a deficiency in the enzyme....?
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1 alpha hydroxylase (found in the kidney)
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pt with stage IV renal disease exhibits insulin resistance. What biochemical pathway in the liver will be elevated
glycolysis/gluconeogenesis/none of the above? |
none of the above
no change in the LIVER biochemical pathways...change in MUSCLEs ability to affect |
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a pt with stage II hypertension and stage III renal disease should consume what type of diet
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Low sodium
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salt sensitivity is more common in what populations? 3
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African Americans
obese geriatric |
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are pts with kidney failure salt sensitive?
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yes
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A patient with nephrotic syndrome in stage II of chronic kidney disease should be treated with .... (2 dietary changes)
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low protein diet
Fish oils (omega 3 fatty acids) (possibly soy) |
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READ THE CASE HE POSTED
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know it
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Besides CKD which independent clinical problem is also responsible for insulin resistance?
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Elevated PTH
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A patient with stage IV renal disease exhibits hyperglycemia, which of the following diets would you NOT recommend and why?
A low carbohydrate diet A high carbohydrate diet A low protein diet A high fat diet A liquid based diet |
A low carbohydrate diet
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Typically patients with stage II renal disease will present with which abnormal laboratory values?
Reduced serum cholesterol Elevated serum low-density lipoprotein Elevated serum cholesterol Elevated serum triglycerides Reduced hemoglobin A1C Elevated hemoglobin A1C Elevated high-density lipoprotein Reduced serum triglycerides |
Elevated serum low-density lipoprotein
Elevated serum cholesterol Elevated serum triglycerides Elevated hemoglobin A1C Elevated high-density lipoprotein |
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The first treatment options for a patient with stage III renal failure, hyperlipidemia and hyperglycemia would be:
Lipid lowering drugs A nutritional assessment To discuss weight loss strategies Diet modification To prescribe weight loss drugs Vitamin Supplementation To Restrict fluids |
A nutritional assessment
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A patient with stage IV renal disease is most likely to have a deficiency in which of the following vitamins?
Vitamin K Vitamin D Vitamin E Vitamin C Vitamin A Vitamin B7 Vitamin B1 Vitamin B2 |
D
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A deficiency of vitamin D in a patient with stage IV renal failure is primarily caused by a deficiency in the enzyme?
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α-hydroxylase1
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A patient with stage IV renal disease exhibits insulin resistance. What biochemical pathway in the liver will be elevated in this patient?
Glycolysis Gluconeogenesis None of the above |
None of the above
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A patient with stage II hypertension and stage III renal disease should consume a:
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Low sodium diet
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Salt sensitivity is more common in
African Americans Obese patients Geriatric patients End-stage renal failure Patients on dialysis Asian Americans |
African Americans
Obese patients Geriatric patients |
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A patient with Stage V CKD or end-stage renal disease on Peritoneal Dialysis will most likely have loss of_______ during dialysis.
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Protein
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A 25-year-old patient with end-stage renal disease has recently undergone a kidney transplant. Which of the following nutritional factors are you primarily concerned about as his family physician
Weight gain Weight loss Vitamin A toxicity Vitamin D deficiency Anemia Zinc deficiency Hypertriglyceridemia Hypotriglyceridemia |
Weight gain
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serum ____ is highly predictive of morbidity/mortality
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albumin
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What stage of kidney disease does this describe?
GFR between 60-89 ml/min/1.73m2 |
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What stage of kidney disease does this describe?
GFR between 30-59 ml/min/1.73m2 |
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What stage of kidney disease does this describe?
GFR between 15-29 ml/min/1.73m2 |
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What stage of kidney disease does this describe?
end stage renal failure: GFR < 15 ml/min/1.73m2 |
5
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basic energy needs to maintain body mass and help kidneys when you have CKD?
what if obese? |
30-35 kcal/kg/day
obese: 30 kcal/kg/day |
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a ___ protein diet is beneficial for a pt with CKD?
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low
A low protein diet (0.3 g vegetable protein/kg/day) supplemented with amino acids and keto analogs can correct metabolic acidosis, secondary hyperparathyroidism, resistance to insulin, and decreased sodium/potassium activity in patients with stage 5 CKD. |
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what is better in helping to change albumin levels, supplement, counseling, or combo?
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combo
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in pts with stage 1-4, what should you restrict sodium to per day?
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2g/day
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CKD patients with stage 1-4 should restrict calcium to less than _____
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1200 mg/day
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what vitamin can be found in EXCESS in pts with renal failure?
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vitamin A
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what should be used in Patients with GFR < 20 ml/min or stage 5
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1,25 dihydroxy vitamin D3 (active D3) should be used
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high fiber diets do what?
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decrease serum urea
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what happens to the energy need of pts with CKD?
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decreases
yet if you have an inflammatory disease, energy expenditure goes up |
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where is the major site for decreased sensitivity to insulin action?
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Skeletal muscle
(impairment of IRS-1 is responsible) |
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what inhibit insulin secretion in CKD
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excess PTH
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what should carb intake be like for someone with CKD?
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moderate to rich
try low glycemic index carbs (due to hyperglycemia) |
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what happens to lipid, TG, and cholesterol levels n CKD
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increase
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what is the relation of dietary K, Ca and Mg to BP?
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inverse relationship
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