Acute Kidney Injury Flashcards
What investigations can indicate AKI in a patient?
Protein/blood in urine
Imbalance of electrolytes
High serum creatinine
Why can trimethoprim increase serum creatinine levels?
Because it slows the excretion of creatinine in the kidneys
How can AKI occur?
Kidney not receiving enough blood
Direct damage to kidneys (sepsis)
Obstructions in the kidneys
Drug-induced
Dehydration
Which cellular component do tubular cells in the kidneys have a lot of?
Mitochondria
What is the difference between the afferent and efferent arteriolar vessels?
Afferent: brings blood to the kidneys
Efferent: brings blood out of the kidneys
What are the presentations/symptoms of AKI?
Decreased urine output
Oedema/SOB
Tiredness
Rash
N+V
Oral ulcers
What are the symptoms of volume depletion, vs. volume overload?
Volume depletion: dry mouth, thirst, excess fluid loss, ankle swelling, weight gain
Volume overload: reduced skin turgor, raised JVP, tachycardia, hypotension
What are examples of some drugs which can cause AKI?
Aminoglycosides e.g. gentamicin, neomycin, streptomycin
NSAIDs
ACEi
MTX
What are the 4 options available to manage AKI within the first 24h?
Fluids for rehydration
Antibiotics for infection
Catheter to remove obstructions
Adjusting/changing current medications (e.g. stopping NSAIDs/ACEi)
What factors to you monitor during acute renal failure?
Pulse
BP
Temp.
Respiratory rate
Urine output
Arterial blood gases
When would dialysis be required for AKI?
Hyperkalaemia
Metabolic acidosis
Multi-organ failure
Fluid overload
Very high serum creatinine/urea levels
How can acute kidney injury be prevented?
Fluids
Stopping AKI-inducing drugs (NSAIDs/ARBs/ACEi, etc)
N-acetyl cysteine
Identifying high risk patients, e.g. elderly, HF, diabetics
