5. AKI

Question 1

what is retained in AKI

Answer 1

creatinine and urea

Question 2

what is the definition of AKI

Answer 2

serum creatinine >26.5 umol/l in 48hrs
OR
rises to 1.5x from baseline in the next 7 days

urine output <0.5 ml/kg/h for 6hrs

Question 3

how is the first stage of AKI diagnosed

Answer 3

creatinine >26.5 umol/l in 48hrs or 1.5x baseline

urine output < 0.5 ml/kg/h for 6-12hrs

Question 4

how is the second stage of AKI diagnosed

Answer 4

creatinine is 2x baseline

urine output < 0.5 ml/kh/h for >12hrs

Question 5

how is the third stage of AKI diagnosed

Answer 5

creatinine is 3x baseline

urine output <0.3 ml/kg/h for >24hrs OR anuria for <12hrs

Question 6

what hormones are produced by the kidneys

Answer 6

renin
vit D
erythropoetin
prostaglandins

Question 7

what are 4 main functions of the kidneys

Answer 7

• excretion of electrolytes
• clear waste products
• control water balance
• regulate acid-base

Question 8

what are the effects of AKI

Answer 8

• fluid overload/pulmonary oedema
• hyperkalaemia
• metabolic acidosis
• uraemia

Question 9

what does a typical ABG show for metabolic acidosis

Answer 9

ph<7.3
pCO2 low
pO2 normal to high
HCO3 low

Question 10

typical symptoms of metabolic acidosis

Answer 10

breathless/tachypnoeic
nausea
non-specifically unwell

Question 11

what are some metabolic waste products that are retained in uraemia

Answer 11

sulphate
urea
ammonia
creatinine
phosphate

Question 12

what are some effects of ureamia

Answer 12

pericarditis
pleurisy
encephalopathy

Question 13

What are indications of life threatening complications of AKI

Answer 13

• severe pulmonary oedema
• severe metabolic acidosis
• severe hyperkalaemia (esp if ECG changes)
• uraemic pericarditis
• uraemc encephalopathy

Question 14

insertion sites for renal replacement therapy

Answer 14

internal jugular vein
femoral vein
subclavian vein