chem medialab

Leading associative cause of CKD?

Diabetes

Commonly use creatinase

Enzymatic

Which of these factors are associated with CKD?

Gwnetics, socieconomic status, obesity,family history, gender, ethnicity, age, birth weight, smoking status, exposure to nephrotoxins, and prior acute kidney injury may be associated with development of the disease.

Both direct measurement and indirect estimates of GFR can be performed. Which one of these is more common?

Indirect estimates are by far more common. Then are relatively non-invasive (a simple blood draw only) and simple to perform in contrast to methods of direct measurement.

Interference with colored molecules producing background can occur

Jaffe (alkaline-picrate)

Reacts to create a yellow/orange/red colored compound

Jaffe (alkaline-picrate)

Which organization is responsible for the formal definition of CKD developed in 2002?

National Kidney Foundation - Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI)

< 30 mg/g

Normal/Mild albuminuria

What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs?A. 9.5 mL/minB. 13.6 mL/minC. 95 mL/minD. 136 mL/minE. 1.36 mL/min

One method of calculating a glomerular filtration rate is using creatinine and urine volume to determine creatinine clearance. The equation is as follows: Creatinine Clearance = (urine creatinine X urine flow rate) / plasma creatinine; where urine flow rate = volume in mL /24 hours x h/60 min) In this case = creatinine clearance = 124 X (2200/24 x hour/60) / 2 = 94.7 or 95 mL/min

The currently recommended equation to estimate the GFR is the:

The CKD-EPI equation is currently recommended by KDIGO for use to estimate GFR due to its superior performance in contrast to the other options presented.

A 45-year-old male of average height and weight had a serum creatinine of 1.5 mg/dL and urine creatinine was 120 mg/dL; the total volume of urine collected over a 24-hour period was 1,800 mL. Calculate the creatinine clearance for this patient in mL/min.

The creatinine clearance for this patient is 100 mL/min. Creatinine clearance values are calculated using the following equation: Creatinine Clearance (mL / min) = (Urine Creatinine / Serum Creatinine) x Urine Volume (mL) / [ time (hr) x 60 ] For this patient Creatinine clearance (mL/min)= (120/1.5) x (1800 / [24 x 60]) 80 x 1800/1440, which is 80 x 1.25, or 100 mL/min

While many laboratory tests are employed in diagnosis and monitoring of CKD, which two are the primary ones used to diagnose, risk stratify, and monitor the disease?

Urine albumin (as a creatinine ratio) and creatinine (to calculate GFR) are the most common tests used to diagnose, risk stratify, and monitor CKD.

Chronic Kidney Disease is defined as

abnormalities of kidney structure and/or function that have implications for long-term health. To be diagnosed, abnormalities must be present for greater than 3 months

Higher levels of urine albumin

are associated with increases in kidney damage

Decreases in GFR may be caused by

both benign and pathologic conditions.

CKD is more prevalent in:

women

Given the following information, calculate the results in mg/24 hrs for a 24 hour urine protein.Total volume for 24 hours = 2400 mL Urine protein = 2.7 mg/dL

2.7 mg/dL X 2400 mL/24 hr X 1 dL/100 mL = 2.7 mg X 2400 100 = 64.8 mg/24 hr

Moderate albuminuria

30-300mg/g

What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs?A. 9.5 mL/minB. 13.6 mL/minC. 95 mL/minD. 136 mL/minE. 1.36 mL/min

C;One method of calculating a glomerular filtration rate is using creatinine and urine volume to determine creatinine clearance. The equation is as follows:Creatinine Clearance = (urine creatinine X urine flow rate) / plasma creatinine; where urine flow rate = volume in mL /24 hours x h/60 min)In this case = creatinine clearance = 124 X (2200/24 x hour/60) / 2 = 94.7 or 95 ml/min

All of the following are considered potential treatment options for patients with CKD?

Reducing blood pressure Improving lifestyle choices associated with poor health Controlling diabetes Kidney transplant

> 300 mg/g

Severe Albuminuria

Lower eGFR is associated with

decreased kidney function

Interference due to suppression of reporter molecules (H2O2) can occur

enzymatic

nephron

functional unit of the kidney

Decreases in serum creatinine are associated with

higher levels of kidney function.