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Kidney Disease

QuestionAnswer
clinical presentation of acute kidney disease changes in urine output, tachycardia, decreased venous and arterial pressure, orthostasis, colored urine, uremia - SOB, fatigue, mental confusion, N/V, bleeding, loss of appetite, edema, flank pain, increased weight, increased BP, elecotrlyte abnormality
Pathophysiology vasodilation of the afferent arterial mediated by prostaglandins (so NSAIDs and COX inhibs interfere); vasoconstriction of the efferent arteriole (mediated by Ag II, so ACE and ARBs interfere)
drugs that cause prerenal failure ACEI/ARBs, COX2, CSP, diuretics, NSAIDs, radioconstrast dye, tacrolimus
drugs that cause intrinsic failure amphetamines, cisplatin, CSP, mitomycin C, gold, heroin, lithium, NSAIDs, phenytoin, analgesics, NSAIDS, penicillins, sulfonamides, tacrolimu, aminos, ampho B, chemo agents, cidofovir, foscarnet, cocaine, ifosfamide, radiocontrast dye, tacrolimus
drugs that cause post renal failure acyclovir, MTX, oxalate, sulfonamides, uric acid, allopurinol, indinavir, sulfadiazine, triamterene
Blood tests show elevated BUN, SCr, electrolytes (K+ and Phosphorous)
blood tests show decreased calcium, bicarb
Stages of CKD I - >90; II - 60-89; III - 30-59; IV - 15-29; V - <15
Epoetin alpha Epogen, Procrit
Darbopoetin Aranesp
Ferrous sulfate Feo-sol, Fer-in-sol, slow FE
Ferrous fumarate femiron, vitron-C
Ferrous gluconate fergon
sodium ferric gluconate IV - ferrlecit
iron sucrose IV - venofer
iron dextran infed, dexferrum - IV
ADRs of calcium phosphate binders hypercalcemia, N/V, abdominal pain, constipation
Sevelamer ADRs Renagel; decreased LDL, increase HDL, N/V
Lanthanum Carbonate Fosrenol; N/V, diarrhea, abdominal pain, constipation
Aluminum constipation, aluminum tox, chalky taste, cramps, N/V
Magnesium side effects diarrhea, hypermagnesemia, cramps, muscle weakness
calcium carbonate products Tums, Oscal 500, Nephro-Calci, Caltrate, Calcarb, CaCO3
Calcium acetate Phos Lo
Sevelamer Renagel
Lanthanum Carbonate Fosrenol
Aluminum Hydroxide AlternaGel, Aphojel, Alu-Cap, Alu-tab, Basaljel
Magnesium carbonate Mag-Carb
Vit D ADR hypocalemia (decreased incidence with Vit D analogs), hyperphosphatemia (decreased incidence with Vitamin D analogs, Adynamic bone disease
Cinacalcet Sensipar
Cinacalcet MOA decreases PTH
Cinacalcet considerations can be used in conjunction with Vit D and phosphate binders; take with food; don't start therapy if corrected Ca < 8.4
Cinacalcet ADRs hypocalcemia, N/V, diarrhea, myalgias
Vitamin D precusor ergocalciferol (drisdol, calciferol)
Active Vitamin D Calcitriol (Calcijex, Rocalciferol)
Vitamin D analogs Paricalcitriol (Zemplar), Doxercalciferol (Hectoral)
Vitamin Supplementation give water soluble vitamins during dialysis
ADRs of water soluble vitamins N/V, headache, pruritis, flushing; B6 - neuropathy, increased aspartate transaminase; Vit C: dizziness, diarrhea, fatigue, nausea; folic acid: headache, rash, pruritis
Vitamin B Complex , Vitamin C, Folic acid nephrocraps, nephrovite, nephrovite Rx, renavite, Biotin Forte
Vitamin B Complex, Vitamin C, folic acid, iron Nephrovite Rx + iron; nephrex Rx
Vitamin B Complex Albee C
Created by: cytoskeletor
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