Renal info

renal questions

1. What is the normal serum sodium (Na) range?

135–145 mEq/L

2. What is the target potassium (K) range in CKD?

3.5–5 mEq/L

3. What is the normal serum chloride (Cl) range?

95–105 mEq/L

4. What is the normal bicarbonate (HCO₃) range?

22–28 mmol/L

5. What is the normal BUN range?

5–15 mg/dL

6. What is the normal serum creatinine (Cr) range?

0.6–1.2 mg/dL

7. What is the normal albumin range?

3.5–5 g/dL

8. What is the normal magnesium (Mg) range?

1.7–2.1 mg/dL

9. What is the normal total calcium (Ca) range?

8.4–10.5 mg/dL

10. What is the CKD stage 5 target calcium range?

8.4–9.5 mg/dL

11. What is the normal phosphorus (P) range?

2.7–4.6 mg/dL

12. What is the CKD stage 5 phosphorus target?

3.5–5.5 mg/dL

13. What is the normal hemoglobin range for females?

12–15 g/dL

14. What is the CKD target hemoglobin range?

10–11 g/dL

15. What is the normal transferrin saturation (%TSat)?

20–40%

16. What is the CKD target %TSat?

30%

17. What is the normal ferritin range for males?

13–220 ng/mL

18. What is the CKD stage 5 ferritin target?

200 ng/mL

19. What is the normal 25(OH)-Vitamin D range?

30–100 ng/mL

20. What is the normal PTH range?

10–65 pg/mL

21. What is the CKD stage 5D PTH target range?

130–585 pg/mL

22. What is the normal arterial blood pH?

7.35–7.45

23. What is the normal PO₂ range?

80–100 mm Hg

24. What is the normal PCO₂ range?

35–45 mm Hg

25. What is the normal HCO₃ in blood gas?

22–26 mEq/L

26. What is the KDIGO SrCr criteria for Stage 1 AKI?

SrCr increase ≥0.3 mg/dL in 48 hrs or 1.5–1.9x baseline

27. What is the KDIGO urine output criteria for Stage 2 AKI?

28. What defines CKD duration?

≥3 months

29. What defines AKI duration?

30. What is the Cockcroft-Gault equation for CrCl?

(140 – Age) × Weight / (72 × SrCr) × 0.85 (if female)

31. When should SrCr be rounded up to 0.8 mg/dL?

In patients ≥65 years with SrCr <0.8 mg/dL

32. What is the IBW formula for females?

45.5 + (2.3 × inches over 60")

33. What is the IBW formula for males?

50 + (2.3 × inches over 60")

34. What is the formula for adjusted body weight?

IBW + 0.4 × (Actual – IBW)

35. What is the BMI formula?

Weight (kg) / Height² (m²)

36. What is the uACR formula?

Urine Albumin / Urine Creatinine

37. What uACR value defines A1 albuminuria?

38. What uACR value defines A3 albuminuria?

300 mg/g

39. What is the formula for corrected calcium?

Measured Ca + 0.8 × (4 – Albumin)

40. What FeNa value suggests pre-renal AKI?

41. What FeNa value suggests intrinsic AKI?

2%

42. What is the AEIOU mnemonic for AKI?

Acid-base, Electrolytes, Intoxication, Overload, Uremia

43. What are common AKI symptoms?

Anorexia, nausea, vomiting, altered mental status

44. What is the urine output threshold for anuria?

45. What is the most common cause of AKI in hospitals?

Pre-renal AKI

46. What drugs cause afferent arteriole vasoconstriction?

NSAIDs, cyclosporine, tacrolimus

47. What drugs cause efferent arteriole vasodilation?

ACEi, ARBs

48. When should ACEi/ARB be stopped due to potassium?

K+ >5.5 mEq/L

49. When should ACEi/ARB be stopped due to SrCr?

SrCr increase >50% or >1 mg/dL

50. What causes acute glomerulonephritis?

Lupus or Group A strep

51. What causes vasculitis-related AKI?

Renal artery thrombosis

52. What drugs cause AIN?

Penicillin, cephalosporins, sulfonamides, NSAIDs, PPIs

53. What is the first step in treating AIN?

Stop the offending drug

54. What drugs cause ATN?

Aminoglycosides, Amphotericin B, IV contrast

55. What is the goal trough for aminoglycosides?

56. What hydration is recommended before Amphotericin B?

≥1L 0.9% NS IV

57. What is the MAP formula?

DBP + 1/3(SBP – DBP)

58. What is the first-line treatment for ECG changes in hyperkalemia?

IV calcium gluconate

59. What drug shifts K+ intracellularly with glucose?

Regular insulin IV + D50W

60. What inhaled drug lowers K+?

Albuterol nebulization

61. When is NaHCO₃ used for hyperkalemia?

If pH <7.2 or HCO₃ <22 mmol/L

62. What is the mechanism of Kayexalate?

Na+/K+ exchange in GI tract

63. What is the mechanism of Lokelma?

Na+-H+/K+ exchange in GI tract

64. What is the mechanism of Veltassa?

Ca2+/K+ exchange in GI tract

65. What defines CKD?

GFR <60 or ACR ≥30 mg/g for ≥3 months

66. What CKD stage is GFR 45–59?

G3a

67. What CKD stage is GFR <15?

G5

68. What is the foundational therapy for CKD?

RAAS inhibitors (ACEi/ARB)

69. What drug class is added to RAASi in CKD?

SGLT2 inhibitors

70. What drug is used for aldosterone breakthrough?

Finerenone

71. What CKD patients benefit from GLP-1 RA?

DMT2 with GFR ≥25 and ACR ≥101

72. What is the mechanism of Finerenone in CKD?

Reduces endothelial dysfunction to prevent albuminuria

73. When is Finerenone indicated?

DMT2 + eGFR ≥25 + ACR ≥30 mg/g despite RAASi ± SGLT2i

74. What potassium level is required to start Finerenone?

K+ ≤ 4.8 mEq/L

75. What is the maintenance potassium goal on Finerenone?

K+ ≤ 5.5 mEq/L

76. What is the action if K+ >5.5 mEq/L on Finerenone?

Hold therapy and restart when K+ <5.0

77. What GLP-1 RAs have CV benefit in CKD?

Dulaglutide, Liraglutide, Semaglutide

78. What is the monitoring for GLP-1 RA therapy?

Hgb A1c, GI side effects, weight

79. What is the benefit of statins in CKD?

Reduce MACE, independent of cholesterol levels

80. When should statins be continued in G5D?

If already on statin before dialysis

81. What is the first-line antiplatelet therapy in CKD?

Aspirin 75–100 mg/day

82. What is the second-line antiplatelet if aspirin is not tolerated?

Clopidogrel

83. What causes metabolic acidosis in CKD?

Renal tubule damage and impaired H+ excretion

84. What causes secondary hyperparathyroidism in CKD?

Hyperphosphatemia and impaired Vitamin D synthesis

85. What causes anemia in CKD?

Decreased erythropoietin (EPO) synthesis

86. What is the BP target for dialysis patients post-dialysis?

87. What is the BP target for dialysis patients pre-dialysis?

88. What antihypertensives are preferred in G5D?

ARB, CCB, non-selective beta blockers (not removed by dialysis)

89. What is the pathophysiology of hypervolemia in CKD?

Reduced GFR → Na+/H2O retention → volume overload

90. What is the initial treatment for hypervolemia in CKD?

Loop diuretics (furosemide, torsemide, bumetanide)

91. What is the mechanism of loop diuretics?

Inhibit Na+ and Cl- reabsorption in the thick ascending limb

92. What electrolyte disturbances can loop diuretics cause?

↓Na+, ↓K+, ↓Mg2+, ↓Ca2+, ↓Cl-

93. What is a major side effect of loop diuretics?

Ototoxicity (dose-related tinnitus or deafness)

94. What drugs increase AKI risk with loop diuretics?

NSAIDs, COX-2 inhibitors, ACEi/ARB

95. What disease can be worsened by loop diuretics?

Gout (due to hyperuricemia)

96. What is the goal potassium level in chronic hyperkalemia?

97. When should potassium binders be started in CKD?

If K+ >5.0–5.5 mEq/L

98. What is the most affordable potassium binder?

Sodium polystyrene sulfonate (Kayexalate)

99. What is a key counseling point for all potassium binders?

Separate from PO meds by 2–3+ hours

100. What is the mechanism of chronic hyperkalemia in CKD?

Reduced renal excretion of potassium