AKT Questins

1. As part of their annual review for hypertension, your patients have urea and electrolytes measured. Significant numbers are now coming back with evidence of chronic renal impairment. Which of the following statements about this condition are true? Select three statements only.

A. Most laboratories now provide a measurement of the patient’s true glomerular filtration rate (GFR) which is a definitive guide to renal function
B.Patients with eGFR > 60 ml/min per 1.73 m2 do not have renal impairment
C.An eGFR < 15 is the cut-off for stage 5 chronic renalimpairment, at which point patients should be considered for dialysis
D. A blood pressure treatment goal of < 125/75 is indicatedfor patients with proteinuria
E. A high-protein diet is required in patients with proteinuria to replace urinary losses
F. Angiotensin-converting enzyme (ACE) inhibitors are contraindicated in patients with only one kidney
G. Patients with moderate-to-severe chronic renal impairment should follow a diet restricted in potassium

Answer: C,D,G

The result measured by laboratories is an estimated GFR (or eGFR), which assumes standard body surface area and race. Patients who have, for instance, had an amputation may receive erroneous results. An eGFR between 60 and 89 correlates with mild renal impairment. Stage 5 chronic kidney disease is defined as eGFR < 15. Low protein diet has been shown to reduce death rate in chronic renal disease. Patients with only one kidney are prone to renal impairment and should all be considered for ACE inhibitors.