Skip to Main Content

Chapter 35. Chronic Kidney Disease/End-Stage Renal Disease

A 79-year-old African American woman with HTN and diabetes presents to her primary care physician for a routine visit. Her spot urine albumin:urine creatinine ratio is 200 mg/g and GFR is estimated at 50 to 55 mL/min/1.73 m2. The patient reports that she does not drink alcohol. She is a smoker but is willing to quit. She participates in an aerobics and strength training class for 30 minutes every day and enjoys a low-sodium diet. Pt denies medication allergies. Medications include lisinopril, metformin, aspirin, and nicotine replacement therapy.

Based on this patient’s ACR, she would be classified as having what category of albuminuria?

a. A1 (normal to mildly increased)

b. A2 (moderately increased)

c. A3 (severely increased)

d. Classification cannot be determined

Answer b is correct. The ACR detects elevated urinary protein (albuminuria) and is a marker of kidney damage. ACR 30 to 300 mg/g is categorized as A2 (moderately increased).

Answer a is incorrect. ACR less than 30 mg/g is categorized as A1 (normal to mildly increased).

Answer c is incorrect. ACR greater than 300 mg/g (or nephrotic syndrome) is categorized as A3 (severely increased).

Answer d is incorrect. ACR, the first method of preference to detect elevated urinary protein (albuminuria), is a marker of kidney damage and can be categorized accordingly.

A 79-year-old African American woman with HTN and diabetes presents to her primary care physician for a routine visit. Her spot urine albumin:urine creatinine ratio is 200 mg/g and GFR is estimated at 50 to 55 mL/min/1.73 m2. The patient reports that she does not drink alcohol. She is a smoker but is willing to quit. She participates in an aerobics and strength training class for 30 minutes every day and enjoys a low-sodium diet. Pt denies medication allergies. Medications include lisinopril, metformin, aspirin, and nicotine replacement therapy.

Based on this patient’s GFR, she would be categorized as having what stage of CKD?

a. Stage 1

b. Stage 2

c. Stage 3a

d. Stage 3b

e. Stage 4

Answer c is correct. Staging is important in that it identifies patients at higher risk of worsening clinical manifestations and complications secondary to CKD. CKD is staged based on GFR. Renal function worsens from Stage 1 (greater than 90 mL/min/1.73 m2) to Stage 5 (less than 15 mL/min/1.73 m...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.