High -Yield Internal Medicine Board Exam Pearls by Knowmedge - HTML preview

Progression

 Try and avoid nephrotoxic agents (NSAIDs, aminoglycoside antibiotics, and

radiocontrast)

 Monitor and control blood pressure with a goal of <130/80 mmHg

 Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers

(ARBs) may slow progression of CKD, especially in patients with proteinuria

 Monitor phosphorous, calcium, and parathyroid hormone levels in all patients with

stage 3 to 4 CKD

 Patients with CKD are at higher risk of cardiovascular events and should be on a baby

aspirin, and a lipid lowering agent with goal LDL <100mg/dL (Maybe <70mg/dL for LDL

in patients with CAD and CKD)

 Consider referral and co-management with a nephrologist if a patient has CKD

progression, active urine sediment and/or stage 3 CKD

 ALL patients with Stage 4 – 5 CKD should be referred to a nephrologist

Pearl # 5: DO NOT Discontinue an ACEI or ARB Because of a Small Increase in Serum