Progressive, irreversible loss of renal function (GFR <15 mL/min) leading to uremia and need for dialysis/transplant.

↑ BUN/Creatinine, Hyperkalemia, Metabolic Acidosis, Hyperphosphatemia, Hypocalcemia, Anemia (low H&H).

Due to decreased erythropoietin (EPO) production. Treated with synthetic EPO (Epoetin alfa). Monitor BP and Hct.

Hyperphosphatemia & Hypocalcemia lead to high PTH, osteodystrophy, vascular calcification which = bone disoders.

Calcium acetate/carbonate, sevelamer, lanthanum. Give WITH MEALS to bind dietary phosphorus in the gut.

Active Vitamin D (calcitriol) or calcimimetics (cinacalcet) to suppress parathyroid gland activity.

"The 4 P's to Restrict": Potassium, Phosphorus, Protein (limited amount), and Fluids (if oliguric). Sodium also restricted.

Caused by calcium-phosphate deposits and uremic toxins. Use phosphate binders, antihistamines, moisturizers, UV light.

Rare. White, powdery urea crystals deposited on the skin from high BUN levels. Sign of severe, untreated uremia.

A life-threatening uremic complication. Sign: Pericardial friction rub on auscultation. Requires urgent dialysis.

"Restless Legs Syndrome," peripheral neuropathy (burning feet), tremors, encephalopathy progressing to coma.

Leading cause of death in ESRD. Hypertension, accelerated atherosclerosis, fluid overload, heart failure, arrhythmias.

Arteriovenous (AV) Fistula is preferred (vein+artery). Takes 6-8 weeks to mature. Assess for thrill and bruit.

NO blood pressures, IVs, or blood draws on the access arm. Teach patient to avoid sleeping on that arm.

Disequilibrium Syndrome

Complication of rapid hemodialysis. Cerebral edema from fluid/electrolyte shifts. S/S: HA, N/V, confusion, seizures.

Peritoneal Dialysis (PD)

Uses peritoneum as a membrane. Dialysate instilled, dwells (exchanges waste), then drained.

Cloudy dialysate effluent, abdominal pain, fever. Culture effluent. Treat with intraperitoneal antibiotics.

Stress meticulous hand hygiene and sterile technique during exchanges to prevent peritonitis.

Definitive treatment. Requires lifelong immunosuppression (e.g., tacrolimus, mycophenolate, prednisone) to prevent rejection.

Adherence to dialysis schedule, dietary/fluid restrictions, medication regimen, and monitoring for complications.

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Chronic Kidney Dise

Question	Answer
Definition	Progressive, irreversible loss of renal function (GFR <15 mL/min) leading to uremia and need for dialysis/transplant.
Lab Variance	↑ BUN/Creatinine, Hyperkalemia, Metabolic Acidosis, Hyperphosphatemia, Hypocalcemia, Anemia (low H&H).
Anemia	Due to decreased erythropoietin (EPO) production. Treated with synthetic EPO (Epoetin alfa). Monitor BP and Hct.
CKD - MBD	Hyperphosphatemia & Hypocalcemia lead to high PTH, osteodystrophy, vascular calcification which = bone disoders.
Phosphate Binders	Calcium acetate/carbonate, sevelamer, lanthanum. Give WITH MEALS to bind dietary phosphorus in the gut.
High PTH treatment	Active Vitamin D (calcitriol) or calcimimetics (cinacalcet) to suppress parathyroid gland activity.
Diet	"The 4 P's to Restrict": Potassium, Phosphorus, Protein (limited amount), and Fluids (if oliguric). Sodium also restricted.
Pruritus	Caused by calcium-phosphate deposits and uremic toxins. Use phosphate binders, antihistamines, moisturizers, UV light.
Uremic Frost	Rare. White, powdery urea crystals deposited on the skin from high BUN levels. Sign of severe, untreated uremia.
Pericarditis	A life-threatening uremic complication. Sign: Pericardial friction rub on auscultation. Requires urgent dialysis.
Neuropathy	"Restless Legs Syndrome," peripheral neuropathy (burning feet), tremors, encephalopathy progressing to coma.
Cardio Risk	Leading cause of death in ESRD. Hypertension, accelerated atherosclerosis, fluid overload, heart failure, arrhythmias.
Hemodialysis	Arteriovenous (AV) Fistula is preferred (vein+artery). Takes 6-8 weeks to mature. Assess for thrill and bruit.
Precautions	NO blood pressures, IVs, or blood draws on the access arm. Teach patient to avoid sleeping on that arm.
Disequilibrium Syndrome	Complication of rapid hemodialysis. Cerebral edema from fluid/electrolyte shifts. S/S: HA, N/V, confusion, seizures.
Peritoneal Dialysis (PD)	Uses peritoneum as a membrane. Dialysate instilled, dwells (exchanges waste), then drained.
PD Peritonitis	Cloudy dialysate effluent, abdominal pain, fever. Culture effluent. Treat with intraperitoneal antibiotics.
PD Aseptic Technique	Stress meticulous hand hygiene and sterile technique during exchanges to prevent peritonitis.
Kidney Transplant	Definitive treatment. Requires lifelong immunosuppression (e.g., tacrolimus, mycophenolate, prednisone) to prevent rejection.
Patient Education	Adherence to dialysis schedule, dietary/fluid restrictions, medication regimen, and monitoring for complications.

Created by: Wasurenboh

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