Renal Physiology and Kidney Disease Flashcards

Which laboratory value is most commonly used to assess dialysis adequacy (Kt/V)?

Answer: Blood urea nitrogen (BUN)

BUN is the primary marker used to calculate Kt/V because urea is freely filtered and its clearance reflects small-molecule uremic toxin removal.

What is the minimum recommended spKt/V per treatment for thrice-weekly hemodialysis per KDOQI guidelines?

Answer: 1.2

KDOQI guidelines recommend a minimum single-pool Kt/V (spKt/V) of 1.2 per treatment for patients on thrice-weekly hemodialysis.

Hyperphosphatemia in ESRD patients is managed through dialysis AND:

Answer: Dietary phosphate restriction and phosphate binders

Because dialysis alone cannot remove enough phosphate, dietary restriction of phosphate-rich foods and phosphate-binding medications are essential adjuncts.

Intradialytic hypotension is most commonly caused by:

Answer: Excessive ultrafiltration rate exceeding plasma refill capacity

When fluid is removed faster than the vascular compartment can refill from interstitial fluid, blood volume drops and blood pressure falls.

Which condition is described as calcification of blood vessels and soft tissues caused by an elevated calcium-phosphate product in ESRD?

Answer: Calciphylaxis

Calciphylaxis is a serious, often fatal complication in ESRD patients characterized by vascular calcification and skin necrosis driven by disordered mineral metabolism.

The primary reason hemodialysis patients are restricted in dietary potassium intake is that:

Answer: The kidneys can no longer excrete potassium, causing dangerous accumulation between treatments

Without functional kidneys, dietary potassium accumulates in the blood between sessions, risking fatal hyperkalemia and cardiac arrest before the next treatment.