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Cheat sheet

CDN Certified Dialysis Nurse Cheat Sheet

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Kidney Disease Concepts

  • 27-29% of exam
  • CKD Stages Electrolytes Acid-Base Anemia Bone Disease

Hemodialysis

  • 51-53% of exam
  • HD Principles Vascular Access HD Complications Water Treatment Symptom Picker

Peritoneal Dialysis

  • 15-17% of exam
  • PD Modalities PD Infections Catheter Care CAPD vs APD

Transplant + Acute Therapies

  • 4-5% of exam
  • Immunosuppressants Rejection CRRT Transplant Basics

Quick Facts

  • Exam CDN
  • Credential Dialysis Nurse
  • Items 150 MCQ
  • Time 3 hours
  • Pass Score 95 (~70%)
  • Fee $350 ($300 ANNA)
  • Valid 3 years
  • Body NNCC via PSI

CKD GFR Stages KI

  • 90 60 30 15 under 15
  • Stage 1: 90+ Stage 2: 60-89 Stage 3: 30-59 Stage 4: 15-29 Stage 5: under 15

CKD vs AKI KI

CKD

  • Months years
  • Irreversible loss
  • Staged GFR

AKI

  • Hours days
  • Often reversible
  • Rapid rise Cr
  • Chronic vs acute

CKD Stages KI

  • Stage 1 GFR 90+ damage
  • Stage 2 GFR 60-89 mild
  • Stage 3 GFR 30-59 moderate
  • Stage 4 GFR 15-29 severe
  • Stage 5 GFR under 15 ESRD
  • AKI Sudden function loss
  • ESRD Permanent kidney failure
  • Nephron Functional kidney unit

CKD Electrolyte Triad KI

  • High K PO4 low Ca
  • K+: hyperkalemia risk PO4: binders needed Ca: low with high PTH

Electrolytes KI

  • Hyperkalemia High serum K+
  • Hypocalcemia Low serum Ca++
  • Hyperphosphatemia High serum PO4
  • Hyponatremia Low serum Na+
  • Phosphate binder Binds dietary PO4
  • Kayexalate K+ exchange resin
  • Calcitriol Active vitamin D
  • Fluid overload Excess volume retention

Acid-Base KI

  • Met acidosis Low HCO3 low pH
  • Resp alkalosis Low CO2 high pH
  • Anion gap Unmeasured anions
  • Bicarbonate Primary buffer base
  • pH 7.35 Lower acidosis limit
  • pH 7.45 Upper alkalosis limit
  • Kussmaul Deep rapid breathing
  • Uremic frost Skin urea crystals

Anemia + Bone KI

  • EPO Stimulates RBC production
  • ESA Erythropoiesis-stimulating agent
  • Iron sucrose IV iron replacement
  • Ferritin Iron storage marker
  • Renal osteodystrophy CKD bone disease
  • PTH Parathyroid hormone
  • Cinacalcet Lowers PTH Ca
  • Albumin Nutrition marker

HD Hypotension HE

  • Fast UF dry weight vasodilate
  • Fast UF: volume shift Below dry weight Vasodilator meds Autonomic neuropathy

AVF vs AVG HE

AVF

  • Native vein
  • Lower infection
  • Longer maturation

AVG

  • Synthetic tube
  • Faster use
  • Higher thrombosis
  • Native vs synthetic

Symptom Picker HE

  • BP drop dizzy → Slow UF ( Hypotension )
  • Leg cramps → Saline bolus ( Volume shift )
  • Chest pain → Stop UF O2 ( Ischemia )
  • Fever chills → Culture access ( Infection )
  • Headache nausea → Lower UF rate ( Disequilibrium )
  • Bleeding site → Reduce heparin ( Anticoagulation )
  • No thrill → Assess clot ( Access failure )
  • Air in line → Clamp clamp off ( Embolism risk )

HD Principles HE

  • Diffusion Solute gradient clearance
  • Ultrafiltration Pressure water removal
  • Dialysate Treatment bath fluid
  • Blood flow 300-500 mL/min
  • Dialysate flow 500-800 mL/min
  • Kt/V Adequacy dose marker
  • URR Urea reduction ratio
  • Recirculation Blood short-circuit

HD vs PD HE

HD

  • In-center machine
  • Vascular access
  • Rapid UF

PD

  • Home peritoneum
  • Catheter access
  • Gentle daily
  • Machine vs peritoneum

Access Picker HE

  • Long-term HD → AVF ( Preferred )
  • Veins poor → AVG ( Synthetic )
  • Urgent start → CVC ( Temporary )
  • Steal symptoms → Surgeon consult ( Ischemia )
  • New fistula → Wait maturation ( 6-8 weeks )
  • Infection fever → Blood cultures ( Bacteremia )
  • High recirc → Reposition needles ( Low clearance )
  • Buttonhole site → Same track ( Reduced pain )

Vascular Access HE

  • AVF Gold standard access
  • AVG Synthetic conduit access
  • CVC Temporary central catheter
  • Steal syndrome Distal ischemia
  • Maturation Fistula vein enlargement
  • Thrill/bruit Normal access sounds
  • Buttonhole Constant-site cannulation
  • ROPE Cannulation mapping

Diffusion vs UF HE

Diffusion

  • Solute clearance
  • Concentration gradient
  • Small molecules

UF

  • Water removal
  • Pressure gradient
  • Volume control
  • Solute vs water

HD Complications HE

  • Hypotension Intradialytic BP drop
  • Muscle cramps Fluid sodium issue
  • Air embolism Venous air entry
  • Bleeding Heparin anticoagulation risk
  • Chest pain Ischemia or hypoxemia
  • Fever Pyrogen or infection
  • Disequilibrium Rapid solute shift
  • Clotting Circuit access thrombosis

Water Treatment HE

  • RO Reverse osmosis purification
  • Chloramine Must be removed
  • Bacteria Under 1 CFU/mL
  • Endotoxin Under 0.25 EU/mL
  • Conductivity Dialysate purity check
  • Hardness Ca/Mg ion level
  • pH monitor Dialysate acid-base
  • Loop system Recirculating water design

Cloudy PD Effluent PE

  • Cloudy pain fever culture
  • Cloudy: peritonitis sign Pain: abdominal Fever: systemic Culture: guide ABX

Peritonitis vs Exit-Site PE

Peritonitis

  • Cloudy effluent
  • Abdominal pain
  • Intraperitoneal

Exit-site

  • Local redness
  • Drainage only
  • Catheter surface
  • Inside vs outside

PD Modalities PE

  • CAPD Manual bag exchanges
  • APD Cycler overnight cycles
  • PD catheter Tenckhoff peritoneal tube
  • Dwell time Fluid in peritoneum
  • Exchange Drain fill cycle
  • Icodextrin Long-dwell osmotic agent
  • Ultrafiltration PD fluid removal
  • Clearance Creatinine urea removal

CAPD vs APD PE

CAPD

  • Manual exchanges
  • Daytime dwells
  • No machine

APD

  • Cycler machine
  • Night cycles
  • Dry day option
  • Manual vs cycler

PD Infections PE

  • Peritonitis Cloudy dialysate pain
  • Exit-site Redness drainage
  • Tunnel infection Subcutaneous tract
  • Gram stain Initial organism guide
  • Culture Definitive antibiotic choice
  • Mupirocin Exit-site prophylaxis
  • Aseptic technique Hand mask drape
  • Catheter secure Prevent trauma pull

Transplant + Acute TR

  • Tacrolimus Calcineurin inhibitor
  • Mycophenolate Antiproliferative agent
  • Prednisone Corticosteroid suppressant
  • Rejection Immune graft attack
  • CRRT Slow continuous replacement
  • Hemofiltration Convection clearance
  • Living donor Preferred transplant source
  • Contraindications Active infection cancer

Common Traps

AVF vs CVC

  • AVF long-term ≠ CVC temporary urgent

Diffusion vs UF

  • Diffusion clears solutes ≠ UF removes water

CKD vs AKI

  • CKD progressive ≠ AKI often reversible

Peritonitis vs exit

  • Peritonitis cloudy effluent ≠ Exit-site local only

Kt/V vs URR

  • Kt/V dose adequacy ≠ URR percent reduction

ESA vs iron

  • ESA stimulates RBCs ≠ Iron replaces stores

Last Minute

  • 1. Weights: 28 / 52 / 16 / 4
  • 2. HD = largest domain
  • 3. AVF = preferred access
  • 4. CVC = temporary only
  • 5. HyperK = kayexalate insulin
  • 6. Hypotension = slow UF saline
  • 7. Cloudy PD = peritonitis culture
  • 8. Kt/V = adequacy marker
  • 9. RO water = chloramine out
  • 10. Pass = score 95 (~70%)

CDN

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