With microalbuminuria 30 300 on 2 occassions or

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Unformatted text preview: ll DM patients with microalbuminuria (30-300 on 2 occassions) or albuminuria (>300 once), regardless of BP If PTH is not at goal, active vitamin D is needed ESRD patients will require activated vitamin D Hgb >12 with ESAs have demonstrated harm. Tsat and serum ferritin MUST be at goal in order to achieve ESA benefit Caution for iron overload **Tsat = [(serum ferritin/total iron binding capacity) x100] Notes -Do not use calcium-based agents in HD patients with Ca2+ >10.2 or PTH <150 -Must take with food; space metal cations 1h before or 3h after binder -Adjust Q2-4 weeks based upon PTH -Must control Ca2+ and P first (vitamin D will increase levels) -Oral has poor absorption and strong GI adverse effects (constipation, cramping); space metal cations and quinolones -200mg elemental iron/day for ND-CKD and PDCKD; weekly IV iron sucrose or sodium ferric gluconate for HD-CKD -Avoid in uncontrolled HTN -Dose adjustments should be +/- 25% -Wait 4 weeks in between dose adjustments (allow time for maturation of erythrocytes)...
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This document was uploaded on 03/14/2014 for the course PHMD 6440 at Northeastern.

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