12. Acute Kidney Failure Flashcards
What 3 things are used to measure kidney function?
Creatinine
eGFR
Urine output
What are the limitations of creatinine?
No reference range as totally dependent on patient’s muscle mass
Slow to respond to change so not useful in acute damage
What are the pre-renal causes of acute kidney failure?
Hypotension
Hepatorenal syndrome
Renal artery stenosis
Renal artery clot
What causes of hypotension can cause acute renal failure?
Severe heart failure
Dehydration
Bleeding
Sepsis
What are the renal causes of acute kidney failure?
NSAIDs Inhibitors of RAAS Gentamicin Vasculitis Interstitial nephritis
What are the post renal causes of acute kidney failure?
Obstruction: prostate, stones, cancer
What are the risk factors for acute kidney failure?
Age Chronic kidney disease Heart failure Liver Medications
How is acute kidney failure prevented?
Monitor the patient
Prescribe fluids
Minimise kidney insults
Manage the acute illness
How should a patient be monitored to prevent acute kidney injury?
Obs and early warning score calculation
Regular bloods
Maintain fluid charts
Record weight daily
What is the fluid prescription to maintain weight?
100mls/kg for first 10kg
50mls/kg for next 10kg
20ml/kg after
Replace loss on top
What is the correct salt prescription?
Na: 2mmol/L/day
K: 1mmol/L/day
What are ‘sick day rules’?
RAAS blockers are stopped when the patients are unwell
What causes of acute renal failure are suggested by immune symptoms such as rash, mouth ulcers etc?
Renal causes
What causes of renal failure are suggest by blood in the urine?
Trauma
Malignancy
Stones
What causes of acute renal failure are suggested by blood and protein in the urine?
Glomerulonephritis
Vasculitis
UTI
Malignant hypertension
