Chronic Kidney Disease Lab

3/26/25, 4:33 AM OneNote Chronic Kidney Disease Wednesday, March 12, 2025 9:06 PM Topic Discussion: Chronic Kidney Disease (CKD) (10 minutes) 1. Background/Introduction a. Introduction: Chronic kidney disease (CKD) is the gradual loss of kidney function, typically over months or years. It can lead to endstage renal disease (ESRD), requiring dialysis or kidney transplant. b. Epidemiology: Affecting approximately 10% of the global population, CKD is more common in individuals with diabetes, hypertension, or a family history of kidney disease. c. Different types/classifications of the disease: ▪ Stage 1: Normal kidney function but evidence of kidney damage. ▪ Stage 5 (ESRD): Kidney function is severely impaired, requiring dialysis or a transplant. d. Risk Factors: (3 for full points) Diabetes, hypertension, obesity, family history, smoking, and high cholesterol 2. Pathophysiology/Etiology CKD progresses due to glomerular damage, leading to a reduction in glomerular filtration rate (GFR) and accumulation of waste products in the blood. 3. Signs and Symptoms a. Pertinent Labs: i. Serum creatinine: Elevated in CKD. ii. eGFR: Used to assess kidney function. iii. Urine albumin: Increased in early-stage CKD. b. Presenting Symptoms: (3 for full points) i. Fatigue, swelling (edema), decreased urine output, shortness of breath, nausea, and confusion (in later stages). c. Assessment/diagnostic criteria/tools: i. Blood tests (creatinine, eGFR), urine tests (albumin-to-creatinine ratio), imaging, and kidney biopsy if necessary 4. Treatment a. Approach to Therapy i. Non-pharmacological (2 for full points) • Dietary changes: Low-protein diet, fluid management, and sodium restriction. • Lifestyle modifications: Smoking cessation, weight management, and regular exercise. ii. Pharmacological (full points: unique clinical pearl for ALL 1st line medication classes/agents) https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 1/2 3/26/25, 4:33 AM OneNote 1. 1st line agents: a. ACE inhibitors or ARBs: Used to control blood pressure and reduce proteinuria. i. ACE inhibitors/ARBs slow CKD progression by reducing blood pressure and proteinuria ii. Monitor for hyperkalemia and renal function. b. Diuretics: To manage fluid retention. c. Erythropoiesis-stimulating agents: For anemia associated with CKD. 2. 2nd line agents: a. SGLT2 inhibitors (e.g., empagliflozin) for renal protection in diabetes and CKD. i. SGLT2 inhibitors protect kidney function and reduce the risk of progression. ii. Associated with weight loss and cardiovascular benefits; monitor for urinary tract infections. b. Duration of therapy: i. Lifelong management is often required, especially in the later stages of CKD. 5. Possible Questions from Evaluators (5 minutes) • Drug Questions: • Brand/Generic: Lisinopril (Zestril), losartan (Cozaar), empagliflozin (Jardiance). • Counseling Points: Emphasize adherence to ACE inhibitors/ARBs for kidney protection. • Monitoring: Regular monitoring of renal function, electrolytes, and proteinuria. • Contraindications: Avoid in patients with hyperkalemia or severe renal impairment. • MOA: ACE inhibitors lower blood pressure and reduce protein excretion. SGLT2 inhibitors help the kidneys remove excess glucose. • Guideline: • KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease • National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 2/2