Renal Pharmacology for Dialysis Nurses Flashcards

Which erythropoiesis-stimulating agent (ESA) is most commonly used to treat anemia of chronic kidney disease in dialysis patients?

Answer: Epoetin alfa

Epoetin alfa is the most widely used ESA for dialysis-associated anemia, stimulating bone marrow production of red blood cells.

What hemoglobin range is targeted when using ESA therapy in dialysis patients according to KDIGO guidelines?

Answer: 10–11.5 g/dL

KDIGO guidelines recommend targeting hemoglobin between 10–11.5 g/dL with ESA therapy to improve quality of life while avoiding the increased cardiovascular risks associated with higher levels.

IV iron supplementation is indicated in dialysis patients when ferritin is below what threshold despite ESA therapy?

Answer: 200 ng/mL

IV iron is commonly indicated when serum ferritin is below 200 ng/mL or transferrin saturation is below 20%, suggesting functional iron deficiency limiting ESA response.

Which phosphate binder is safe to use in dialysis patients with hypercalcemia?

Answer: Sevelamer hydrochloride

Sevelamer is a non-calcium, non-aluminum phosphate binder that effectively lowers serum phosphorus without contributing to hypercalcemia.

Cinacalcet (Sensipar) is used in dialysis patients primarily to treat which condition?

Answer: Secondary hyperparathyroidism with elevated PTH

Cinacalcet is a calcimimetic that increases the parathyroid gland's sensitivity to calcium, suppressing PTH secretion and treating secondary hyperparathyroidism.

Which antihypertensive class is preferred for dialysis patients with diabetic nephropathy to slow residual kidney disease progression?

Answer: ACE inhibitors or ARBs

ACE inhibitors and ARBs block the renin-angiotensin-aldosterone system, reducing intraglomerular pressure and proteinuria, thereby slowing CKD progression.