Acute kidney injury Flashcards
NICE criteria for AKI
Rise in creatinine >25micromol/L in 48 hours
Rise in creatinine >50% in 7 days
Urine output <0.5ml/kg/hour for >6 hours
Risk factors for AKI
CKD
Heart failure
Diabetes
Liver disease
Older age
Cognitive impairment
Nephrotoxic medications (NSAIDs and ACEi)
Use of contrast medium
Pre-renal causes
Most common cause of AKI
Due to inadequate blood supply to kidneys
Dehydration (diarrhoea/ vomiting)
Hypotension (shock)
Heart failure
Renal causes
Glomerulonephritis
Interstitial nephritis
Acute tubular necrosis
Rhabdomyolysis
Post-renal causes
Caused by obstruction to the outflow
Kidney stones
Masses (cancers)
Strictures
Enlarged prostate or prostate cancer
Symptoms and signs
Reduced urine output
Pulmonary and peripheral oedema
Arrhythmias
Features of uraemia
Drugs to stop in AKI
NSAIDs
Aminoglycosides
ACEi
Angiotensin II receptor antagonists
Diuretics
Management
IV fluids in pre-renal AKI
Stop nephrotoxic medications
Relieve obstruction in post-renal
Complications
Hyperkalaemia
Fluid overload, heart failure and pulmonary oedema
Metabolic acidosis
Uraemia leading to encephalopathy or pericarditis