Hyperphosphatemia and vascular calcification in chronic kidney disease

1.Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD).

a) True
b) False

2.Epidemiological data by Dialysis Outcomes Practice Patterns Study (DOPPS) showed that patients with CKD and hyperphosphatemia who have maintained their phosphate level close to normal for _______ months have lower mortality levels.

a) 2 months
b) 4 months
c) 6 months
d) 8 months

3. What is the normal range for serum phosphate?

a) 135-145 mmol/L
b) 0.81-1.58 mmol/L
c) 35-45 mmol/L
d) 10-20 mmol/L

4. Which of these play a role in phosphate homeostasis?

a) Calcitriol
b) PTH
c) Fibroblast growth factor 23
d) All of the above

5. Which of these processes do not play a role in phosphate maintenance?

a) Hepatic clearance
b) Renal handling
c) Intestinal absorption
d) Transcellular movement between intracellular fluid and bone storage pool

6. Calcification in what area most indicates risk of cardiovascular events and mortality in hemodialysis (HD) patients?

a) Descending aorta
b) Upper part of the abdominal aorta
c) Lower part of the abdominal aorta
d) Aortic arch

7. What is the criterion recommended by the KDIGO Working Group as screening for vascular calcification in patients?

a) Hyperphosphatemia and a GFR > 90
b) Hypercalcemia and a GFR > 60
c) Hyperphosphatemia and a GFR < 60
d) Hypophosphatemia and a GFR > 90

8. Vascular calcification is a(n) _____ process that is driven partly by _____cells, which are sensitive to changes in ______.

a) Active; cardiac muscle; T3, T4, and TSH
b) Active; smooth muscle; phosphate, calcium, and PTH
c) Passive; smooth muscle; phosphate, calcium, and PTH
d) Passive; cardiac muscle; TSH, calcium, and insulin

9. Vascular calcification essentially turns the walls of blood vessels into bone.

a) True
b) False

10. According to the literature, what percentage of patients struggle with maintaining their phosphate level below 1.58 mmol/L?

a) 50%
b) 30%
c) 77%
d) 34%

11. According to the literature, on average, dialysis patients take _______ phosphate binders daily.

a) 2.5
b) 6.8
c) 10.8
d) 12.5

12. Which of these phosphate binders creates an environment conducive to the development of vascular calcification?

a) Sevelamer hydrochloride
b) Lanthanum carbonate
c) Sucroferric oxyhydroxide
d) Calcium carbonate

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