Control phosphate and prevent calcifications leading

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Unformatted text preview: opathy) a. Control phosphate and prevent calcifications leading to ocular damage 9. Peripheral neuropathy (i.e. RLS, paresthesias, paralysis) 10. Psychological (i.e. depression, anxiety, psychosis) Important Laboratory Markers and Goals per ADA, JNC, and K/DOQI Guidelines: Parameter Goal Recommended if Not at Notes Goal <130/80 (no proteinurea) ACE-I (T1/2DM, nondiabetic ACE-I are recommended BP <125/75 (proteinurea) CKD) or alternative: ARB (T2M, nondiabetic CKD) <55 ≥ 30 ng/mL Phosphate binder Vitamin D precursors Activated vitamin D Hgb 35-70 (Stage 3) 70-110 (Stage 4) 150-300 (Stage 5) 11-12 g/dL TSat** >20% Iron supplementation Serum ferritin >100 ng/mL >200 ng/mL (in HD) Ca2+ x P* 25-OHD (PTH at goal) PTH Erythropoeitic-Stimulating Agent *Corrected Ca2+= Serum C2++ 0.8(4.0 – Albumin) Treatment Considerations: Agent Options Calcium carbonate/citrate, Phosphate sevelamer, lanthanum, binder aluminum, magnesium Vitamin D Iron ESA Inactive: Ergocalciferol (D2), Cholecalciferol (D3) Active: Doxercalciferol, paricalcitol (analogs), Calcitriol PO: Ferrous sulfate, ferrous fumarate, ferrous gluconate, polysaccharide iron, heme iron polypeptide IV: Iron dextran, iron sucrose ferric gluconate, ferumoxytol Erythropoietin (Epogen or Procrit), darbepoietin (Aranesp) in a...
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