The Intern At Work: Internal Medicine 272. (Repeat) The Internist's Guide To CKD
Feb 23, 2025
Dr. Lisa Dubrofsky, a nephrologist from Toronto with expertise in hypertension and cardiology, shares vital insights on chronic kidney disease (CKD) management. She discusses pivotal changes in CKD guidelines, including the significance of albuminuria and standardized equations for kidney function assessment. Dr. Dubrofsky also explores the potential of cystatin C as a diagnostic marker and highlights innovative treatments, such as SGLT2 inhibitors and finirinone, reshaping nephrology. Get ready for an engaging dive into the future of kidney care!
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Enhanced CKD Classification
- The 2012 CKD guidelines added cause and albuminuria classification to the staging of CKD.
- Albuminuria levels strongly predict CKD progression and cardiovascular mortality risk.
Preferred GFR Equation
- Use the CKD-EPI creatinine equation for estimating GFR as it is more accurate across a wide GFR range.
- Avoid older equations like Cockcroft-Gault when possible due to assay standardization issues.
Cystatin C's Limited Use
- Cystatin C is an alternative kidney filtration marker released by all nucleated cells.
- In Canada, it is rarely used due to cost, limited impact on management, and availability.