CSR CKD Stages and Dietary Management

Question 1

According to KDIGO 2012, CKD Stage 3 is further divided into 3a and 3b based on GFR thresholds. What GFR range defines Stage 3b?

Accepted Answer

GFR 30–44 mL/min/1.73m²

Answer

CKD Stage 3b is defined by GFR 30–44 mL/min/1.73m², representing moderately to severely decreased kidney function. Stage 3a covers GFR 45–59 mL/min/1.73m² (moderately decreased).

Question 2

In early CKD (Stage 1–2), the dietary intervention with the STRONGEST evidence for preserving kidney function in patients with diabetic nephropathy is:

Accepted Answer

Sodium-glucose cotransporter-2 (SGLT2) inhibitor therapy combined with blood glucose control and dietary sodium restriction

Answer

In diabetic nephropathy, optimal glycemic control (HbA1c <7%), SGLT2 inhibitors (renoprotective effect via hemodynamic and metabolic mechanisms), and sodium restriction form the evidence-based cornerstone of early CKD management.

Question 3

For a CKD Stage 4 patient (GFR 20 mL/min) with hyperphosphatemia, when should phosphate binders be taken to maximize efficacy?

Accepted Answer

Taken during or immediately after meals containing phosphorus

Answer

Phosphate binders must be taken with meals containing dietary phosphorus because they work by binding phosphate in the GI tract before absorption. Timing with food maximizes the binding of dietary phosphate.

Question 4

A CKD Stage 3 patient on an ACE inhibitor develops serum potassium of 5.8 mEq/L. Which dietary approach is the FIRST-LINE recommendation?

Accepted Answer

Implement a moderate potassium restriction of 2000–2500 mg/day with leaching techniques for high-potassium vegetables

Answer

Moderate potassium restriction (2000–2500 mg/day) combined with food preparation techniques (leaching/boiling vegetables) is the appropriate first dietary step for mild-moderate hyperkalemia in CKD, rather than overly restrictive limits that may impair diet quality.

Question 5

The 'KDIGO heat map' used for CKD staging considers two variables to predict CKD progression risk and prognosis. What are these two variables?

Accepted Answer

GFR category (G1–G5) and albuminuria category (A1–A3)

Answer

The KDIGO CKD prognosis table (heat map) uses GFR categories (G1–G5) on one axis and albuminuria categories (A1: <30 mg/g, A2: 30–300 mg/g, A3: >300 mg/g) on the other, with color coding (green/yellow/orange/red) indicating risk of CKD progression.

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

CSR CKD Stages and Dietary Management