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Urinary > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

1
Q

How is an Acute Kidney Injury defined?

A

An increase in creatinine:
>26.5 umol/l for 48 hrs
1.5x baseline for 7 days

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2
Q

How many stages of AKI are there?

A

3

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3
Q

What are the stages of AKI

A

AKI 1
AKI 2
AKI 3

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4
Q

Define AKI 1

A

Serum creatinine 1.5-1.9 x increases or >26.5 umol.l

MOST COMMON

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5
Q

Define AKI 2

A

2.0-2.9x baseline

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6
Q

Define AKI 3

A

3.0 x baseline

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7
Q

What are the immediate dangers for life of an AKI 3

A 
Acidosis
Electrolyte imbalance 
Intoxication (lithium) 
Overload 
Uraemic complications
  - uraemic pericarditis
  -Encephalopathic
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8
Q

Is creatinine reabsorbed by the kidney ?

A

No

it is only increased in the blood due to a reduced GFR f

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9
Q

What are the categories of aetiology for AKI

A

Prerenal
Post-renal
Intrinsic

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10
Q

What are the pre-renal causes of AKI

A 
Anything that causes hypoperfusion to kidney 
Cardiac failure 
Haemmorhage
Sepsis 
Vomitting and Diarrhoea 
Hypovolaemia
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11
Q

What are the post-renal causes of AKI

A

Anything delaying/obstructing the normal flow of urine
Tumours - Lymphoma (compresses both ureters)
Prostate disease - BPH
Stones

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12
Q

What are the intrinsic causes of AKI (x6)

A 
Glomerulonephritis 
Vasculitis 
Radiocontrast
Myeloma 
Rhabdomyalosis 
Drugs
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13
Q

What drugs can causes an intrinsic AKI

A

NSIADS

Gentomycin

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14
Q

What is the rare aetiology of AKI

A

Intrinsic AKI

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15
Q

What are risk events of AKI

A 
Sepsis 
Toxin (x-ray contrast, NSAIDS, gentamicin) 
Hypotension
Hypovolaemia
Major surgery
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16
Q

When do you activate the the STOP AKI prevention care bundle

A

When there is 1 or more risk factors

17
Q

What is the STOP AKI prevention bundle

A

Sepsis (if suspec screen and treat)
Toxin (avoid toxins)
Optimise BP volume status (avoid incorrect medication)
Prevent Harm - daily U and Es, fluid balance and medication review

18
Q

If patients that take medication are off sick with vomitting/diarrhoea what should they be told to help prevent AKI

A

Stop taking medications for 24-48hrs

19
Q

What are the medicines to stop on sick days (x5)

A 
ACE inhibitors 
ARBS 
NSAIDS 
Diuretics 
Metformin
20
Q

On examination of patients with AKI what could you expect to find?

A

Axillary arm pit dryness

Palpable bladder

21
Q

What should you do if you can palpate patients bladder

A

insert catheter

22
Q

If you suspect an AKI what should the process be to treat

A

SHOUT

Suspect sepsis 
Hypovoleamia - assess volume status 
Obstruction - consider bladder scan/ultrasound
Urinalysis - ensure its performed 
Toxins - consider stopping toxins

Urinary (13 decks)

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