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CKD Stages and Dietary Management Flashcards

6 cards from real CSR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which of the following is the correct relationship between albuminuria and CKD staging per KDIGO 2012 classification?

    Answer: Albuminuria category A2 (moderately increased, 30–300 mg/g) corresponds to 'microalbuminuria' in older terminology

    KDIGO 2012 renamed 'microalbuminuria' to A2 (moderately increased albuminuria, 30–300 mg/g creatinine), avoiding the misleading 'micro' prefix. A1 is 300 mg/g (severely increased, previously 'macroalbuminuria').

  2. A patient with CKD Stage 5 (GFR 8 mL/min) who is not yet on dialysis has severe uremic symptoms and a serum potassium of 6.5 mEq/L. In addition to urgent potassium-lowering measures, what dietary recommendation is MOST critical?

    Answer: Enforce strict potassium restriction (<1500 mg/day) while expediting nephrology referral for dialysis initiation discussion

    At Stage 5 with severe hyperkalemia (K+ ≥ 6.5 mEq/L), strict potassium restriction (< 1500–2000 mg/day) is urgent to prevent life-threatening cardiac arrhythmias, while simultaneously coordinating with nephrology for timely dialysis initiation.

  3. In managing CKD patients, the 'phosphorus-to-protein ratio' concept is used to guide food selection. Foods with a lower phosphorus-to-protein ratio are preferred. Which food has the LOWEST phosphorus-to-protein ratio?

    Answer: Egg whites

    Egg whites have an extremely low phosphorus-to-protein ratio (~1 mg P/g protein), as the yolk contains almost all egg phosphorus while egg whites provide high-quality protein with virtually no phosphorus.

  4. According to KDOQI 2020, at what CKD stage should patients ideally be referred to a registered renal dietitian for medical nutrition therapy (MNT)?

    Answer: At CKD Stage 3 (GFR < 60 mL/min/1.73m²) or earlier if the patient has diabetes, hypertension, or proteinuria

    KDOQI 2020 recommends MNT referral for all CKD patients at Stage 3 (GFR < 60 mL/min) or earlier for high-risk groups (diabetes, hypertension, significant proteinuria), enabling proactive dietary intervention before complications arise.

  5. A patient with CKD Stage 4 and diabetes has an HbA1c of 9.2%. The care team is considering tighter glycemic control. What consideration is SPECIFIC to CKD Stage 4 patients regarding glycemic targets?

    Answer: HbA1c may be unreliable in advanced CKD due to altered red blood cell lifespan; hypoglycemia risk increases with reduced renal insulin clearance — target HbA1c 7–8% with individualization

    In advanced CKD, HbA1c is unreliable (hemolysis, RBC transfusions, and EPO use affect RBC lifespan). Additionally, the kidney metabolizes ~30% of insulin clearance — reduced in CKD, increasing hypoglycemia risk. Target HbA1c 7–8% with individualization per KDIGO 2020.

  6. Which dietary pattern has shown the most evidence for slowing CKD progression and reducing cardiovascular risk in CKD Stage 1–3, beyond simple macronutrient manipulation?

    Answer: Plant-predominant dietary patterns (Mediterranean or modified DASH) low in processed foods, sodium, and animal protein

    Plant-predominant dietary patterns (Mediterranean, modified DASH, plant-based) reduce CKD progression risk, cardiovascular events, and mortality in observational and intervention studies, through mechanisms including lower uremic toxin production, higher alkali load, reduced phosphorus bioavailability, and favorable microbiome effects.