Chronic Disease Management Flashcards

Per the 2020 KDOQI guideline, what protein intake is recommended for a metabolically stable adult with CKD stage 3-5 not on dialysis and without diabetes?

Answer: 0.55-0.60 g/kg/day

KDOQI 2020 recommends 0.55-0.60 g/kg/day (or 0.28-0.43 g/kg/day with keto-acid analogs) under close supervision.

What daily protein intake does KDOQI 2020 recommend for a metabolically stable older adult on maintenance hemodialysis?

Answer: 1.0-1.2 g/kg

Dialysis removes amino acids and increases catabolism, so 1.0-1.2 g/kg/day is recommended.

An older adult with CKD has a serum potassium of 5.8 mEq/L; which fruit is the best lower-potassium choice?

Answer: Apple

Apples are low in potassium, whereas bananas, orange juice, and cantaloupe are high-potassium foods.

Why are processed foods especially problematic for phosphorus control in CKD?

Answer: Inorganic phosphate additives are absorbed at a much higher rate than plant phosphorus

Inorganic phosphate additives are about 90% absorbed, far more than phytate-bound phosphorus in plant foods.

According to FDA labeling, at what eGFR is metformin contraindicated?

Answer: <30 mL/min/1.73 m2

Metformin is contraindicated at eGFR <30, and initiation is not recommended at eGFR 30-45.

What sodium intake does KDOQI 2020 recommend for adults with CKD to help control blood pressure and volume?

Answer: <2,300 mg/day

KDOQI 2020 recommends limiting sodium to less than 100 mmol (about 2.3 g) per day in CKD.

An older adult on hemodialysis has a phosphorus level of 7.2 mg/dL and takes a phosphate binder at bedtime; what is the best counseling point?

Answer: Take the binder with meals and snacks

Phosphate binders work by binding dietary phosphorus in the gut, so they must be taken with food.