CV: sodium and water retention, HTN, pulmonary edema
GI: Anorexia, hiccups, metallic taste, GI bleeding
CNS: Neuromuscular irritability, cramps, restless leg, neuropathy, encepalopathy
Heme: ANEMIA, bleeding, plateley dysfunction
Bone: Renal osteodystrophy
Derm: Dry skin, pruritis, calcium phosphate deposite.
>500 mg/day of protein in the urine is irreversible
>300 mg/day of protein in the urine is considered microalbumineria and is reversible
>1000 mg/day of proetin in the urine is reversible
Intensive glucose control (targeting BG
ACEI may slow the progression but ARBs have been shown not to slow the progression
CCBs (nondihydropyridines) such as diltiazem and verapamil have been shown to slow the progression
CCBS (dihydropyridines) such as diltiazem and verapamil have been shown to slow the progression
Prophylactically prior to surgery
Restricting phosphorous intake to 800-1200 mg/day
Use a phosphate binder such as aluminum salt
Use a phosphate binder such as calcium salt
Calculate the CaxPO4 to see if it is >55.
Look to sevelamer or lanthanum if CaxPO4 is >55.
Use c alcitriol (natural active vitamin D) or paricalcitol/doxercalciferon (inactive vitamin D)