Week 1: GFR Estimation (Nguyễn)

latin term for kidney is what

renes

what refers to anything related to kidneys

renal

volume of plasma that is filtered by glomeruli of the kidneys per unit of time is what

glomerular filtration rate

creatinine is filtered and cleared at the glomerulus so measuring creatinine clearance is an estimate of what

estimate of GFR

creatinine is filtered at glomerulus and excreted into urine

true

how to measure creatinine

blood sample taken

24 hour urine sample collected

because creatinine undergoes tubular section, it causes an what of CrCl by ~10% in subjects with normal kidney function

overestimation

what can cause an increase in serum creatinine

rhabdomyolysis

creatinine supplement

diet

things that can cause a decrease in serum creatinine

amputation

malnutrition

muscle wasting

medication

CrCl overestimates renal function by what in subjects with normal kidney function (because creatinine undergoes tubular secretion)

~10%

not accurate to use when patients have a acute kidney because in SCr will lag behind the GFR’s decline by 1-2 days to slow accumulation, increased tubular secretion, and increased extra renal clearance

true

the older you are, what happens to CrCl

decrease

more weight, what happens to CrCl

increases

when to use estimated GFR

use in patients with chronic kidney disease

what is the goal urine output

>0.5ml/kg/hr

when to use Cockcroft Gault

estimate CrCl (for drug dosing)

when to use MDRD & CKD-EPI

eGFR (for CKD staging)

loading dose is not dependent on elimination

true

maintenance dose is dependent on what

elimination

what are the select drugs that require dose adjustment

• low molecular weight heparins

• direct oral anticoagulant

• digoxin

• opioids

• metoclopramide

• lithium

• vancomycin

• aminoglycosides

• most antibiotics

• levetiracetam

which oral anticoagulant does not need to be reanlly adjusted

warfarin

which opioid does not need to be really adjusted

fentanyl

decrease muscle equals what to serum creatinine

decrease