19 Acute Kidney Injury Flashcards
What % of the cardiac output does the kidney receive? Why is this relevant?
25% (myocardium receives same amount as cortex)
What is the mortality rate for acute kidney injury?
25-50%
(increased mortality rate with co-morbidities)
Define Acute Kidney Injruy
Decline in GFR in short period of time
(usually measured by increase in creatinine)
What are the NICE guidlines for the detetection of acute kidney injury (ie what changes would constitute acute kidney injury in a patient)?
Define oliguria and anuria.
- Oliguria
- <500mL urine per day
- <20mL urine per hour
- Anuria
- <100mL per day
What does anuria indicate as the cause for acute kidney injury?
- Blockage of urine flow
- Very severe damage to kidneys
Less common than oliguria with AKI
Why is oliguria defined as <500mL urine per day?
Uraemia is a clinical sign of kidney failure. What is it?
a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys
Acute kidney injury can be classified into 3 categories, which of these is the most common?
Pre-Renal, Renal, Post-Renal
90%= pre-renal
Define pre-renal disease (causing acute kidney injury).
Pre-renal disease= decreased renal perfusion
(reversible if recognised quickly enough)
Which cells in the kidney tubule are most sensitive to lack of oxygen?
Proximal tubules as less well perfused part of kidney
Give some causes of pre-renal AKI.
Give some causes of renal and post-renal AKI.
Outline how a patient with an acute kidney injury should be treated.
If a patient has acute kidney injury and their urine looks like this, what is the likely cause of AKI?
Rhabdomyolysis- breakdown of myoglobin- indicates muscle destruction- excreted in urine- causes damage to kidney
What can be seen in the following image?
What prevention methods are used for AKI? (think CVS)
Manage cardiovascular conditions
Remember: patients with co-morbidities at much higher risk of AKI- body can’t cope with eg dehydration or sepsis
