Acute Kidney Injury Flashcards

1
Q

what is an acute kidney injury?

A

A sudden decline in function & rapid progressive

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2
Q

is an acute kidney injury reversible?

A

it can be

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3
Q

what labs would you find with an acute kidney injury

A

decreased GFR so <90
decreased uOP so <30 mL/ hour, or <400 mL/day
increased BUN so >20
Increased creatinine so >1.2

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4
Q

what does AKI often follow?

A

severe, prolonged hypotension, hypovolemia, or exposure to nephrotoxic agents

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5
Q

what is the most common cause of pre-renal AKI

A

decreased cardiac output, so hypotension, hypovolemia, decreased perfusion to kidneys

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6
Q

what is the most common cause of intrarenal AKI

A

acute tubular necrosis

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7
Q

what is an example of a post renal AKI

A

BPH (benign prostatic hypertrophy)

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8
Q

what are the clinical manifestations for aKI

A
  • oliguria <400 ml/day
  • begins 1 day after hypotensive event and lasts 1-3 days
  • fluid volume excess (Why? you aren’t peeing)
  • metabolic acidosis
  • hyponatremia (disoriented, confused)
  • hyperkalemia
  • waste product accumulation (BUN & cr)
  • neurologic disorders
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9
Q

Treatment for aKI

A

Correct fluid and electrolyte imbalances, especially hyperkalemia and excess fluid volume

  • manage BP
  • prevent/treat infections
  • maintain nutrition
  • avoid nephrotoxic drugs
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10
Q

how to lower serum potassium?

A
  • dietary restriction
  • potassium binders (patiromer, sodium zirconium cyclosilicate, and sodium polystyrene sulfonate)
  • Calcium gluconate IV (lessens risk of dysrhythmias)
  • dextrose and insulin – pushes into cells
  • sodium bicarbonate– correct acidosis & pushes k into cells
  • hemodialysis
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11
Q

when should you NOT give sodium polystyrene sulfonate (kayexalate)

A
  • do not use for emergency life threatening hyperkalemia due to delayed onset
  • do not give if paralytic ileus
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12
Q

who is going to KILL this exam?

A

ALL OF US

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