Acute Kidney Injury Flashcards
what is AKI
problems with kidneys that is reversible
risk factors
hypovalaemic over 75 co-morbidites CKD toxic drugs like NSAIDs use of contrast
causes
pre-renal
renal
post-renal
pre-renal
hypovalaemic or reduced CO
examples:
shock
sepsis
renal
renal incompetence
examples: glomerulonephritis Acute interstitial nephritis Acute tubular necrosis haemolytic uraemic syndrome
post-renal
obstruction
examples:
ureter calculi
tumour
investigations
U+Es urine dipstick USS ABG - hypoxia ECG - hyperkalaemia
management
ABCDE
fluid assessment
remove nephrotoxic drugs
management of underlying cause
nephrotoxic drugs
Diuretics
ACEI
Metformin
NSAIDs
anti-coagulation
digoxin
gentamicin
complications
metabolic acidosis hyperkalaemia pericarditis - uraemia encephalopathy - uraemia oedema
AKI stages
- creatinine levels
- urine output
1 - <0.5ml/kg/hr OR 1.5-1.9 increase in Cr in 6hrs
2 - <0.5ml/kg/hr OR 2-2.9 increase in Cr in 12hrs
3 - <0.3ml/kg/hr OR >3 increase in Cr in 24hrs or levels of 353.6
use the worst outcome to determine stage
indication for dialysis
Acidosis Electrolyte imbalance Intoxicity Oedema Uraemia
what drugs directly affects the kidneys
NSAIDs
what is an acceptable kidney issue when starting ACEI
rise in creatine by max of 30%
reduction in eGFR by max of 25%
what is given to manage hyperkalaemia
Ca Gluconate
