Acute Kidney Injury Flashcards
START FROM ACUTE TUBULAR NECROSIS
Kidney receives ______% of the CO
20
Acute Kidney Injury is defined as an abrupt (within ____ hours) reduction in kidney function, an absolute increased in serum creatinine greater than or equal to ____ mg/dl, an increase in serum creatinine greater than or equal to ____ from baseline, or a reduction in urine output less than or equal to ____ ml/kg per hour for more than 6 hours.
48 hours; 0.3 mg/dl; 50%; 0.5 ml/kg
This is an important determinant of long-term survival after Cardiovascular Surgery
Acute Kidney Injury
True/False
Research suggests that even after complete recovery of renal function after a CV surgery, patient survival rate was the same as not having AKI after the surgery.
False, Even with complete renal function recovery, patient survival rate was still lower.
Normal Value for Na+ on the Basic Metabolic Profile
135-145
Normal Value for Cl- on the Basic Metabolic Profile
95-103
Normal Value for BUN on the Basic Metabolic Profile
4-23
Normal Value for Bicarb on the Basic Metabolic Profile
22-26
Normal Value for K+ on the Basic Metabolic Profile
3.6-5.2
Normal Value for Creatinine on the Basic Metabolic Profile
0.8-1.3
Normal Value for Glucose on the Basic Metabolic Profile
90-115
This type of AKI is defined as a sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury.
Post-renal AKI
This type of AKI is defined as a sudden and severe drop in blood pressure (shock) or interruption of blood flow to the kidneys from severe injury or illness.
Pre-renal AKI
This type of AKI is defined as a direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply.
Intrarenal AKI
What is important to ask in a history when suspecting AKI?
- Volume Loss
- Dehydration
- Medications
- Radiocontrast Use
- GI Bleeding
- Steroids
- TPN
What Imaging Studies would you use to check for suspected AKI?
- Ultrasound
- CT
- MRI/MRA
What lab studies will you use to check for suspected AKI?
- Biochemical Tests (BUN/Creat)
2. Urinalysis (Electrolyres, Eosinophils)
What interventions can be used in a patient with AKI?
- Fluid challenge
2. Foley catheter
DDx for Prerenal Azotemia
- Etiology: Poor renal perfusion
- Serum BUN:Cr Ratio : > 20:1
- U(Na): 500
- Urinary Sediment: Benign or hyaline casts
Fractional Excretion of Na+
(Urine (Na) / Plasma (Na)) / (Urine (Cr) / Plasma (Cr)) x 100%
In pre-renal AKI, what are common characteristics that you will see in relation to the nephron?
- Decreased Blood Flow
- Decreased Excretion of Na and water
- Tubules conserve Na and water
About how long does a hospitalization need to be to treat elevated BUN/Creatinine in a person with prerenal AKI (to return it back to normal)
About 7 days
What does BUN stand for?
Blood urea nitrogen
What does BUN test for?
Measures the amount of nitrogen in your blood that comes from the waste product urea.
