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Nephrology > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

START FROM ACUTE TUBULAR NECROSIS

1
Q

Kidney receives ______% of the CO

A

20

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2
Q

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.

A

48 hours; 0.3 mg/dl; 50%; 0.5 ml/kg

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3
Q

This is an important determinant of long-term survival after Cardiovascular Surgery

A

Acute Kidney Injury

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4
Q

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.

A

False, Even with complete renal function recovery, patient survival rate was still lower.

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5
Q

Normal Value for Na+ on the Basic Metabolic Profile

A

135-145

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6
Q

Normal Value for Cl- on the Basic Metabolic Profile

A

95-103

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7
Q

Normal Value for BUN on the Basic Metabolic Profile

A

4-23

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8
Q

Normal Value for Bicarb on the Basic Metabolic Profile

A

22-26

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9
Q

Normal Value for K+ on the Basic Metabolic Profile

A

3.6-5.2

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10
Q

Normal Value for Creatinine on the Basic Metabolic Profile

A

0.8-1.3

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11
Q

Normal Value for Glucose on the Basic Metabolic Profile

A

90-115

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12
Q

This type of AKI is defined as a sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury.

A

Post-renal AKI

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13
Q

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.

A

Pre-renal AKI

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14
Q

This type of AKI is defined as a direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply.

A

Intrarenal AKI

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15
Q

What is important to ask in a history when suspecting AKI?

A
  1. Volume Loss
  2. Dehydration
  3. Medications
  4. Radiocontrast Use
  5. GI Bleeding
  6. Steroids
  7. TPN
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16
Q

What Imaging Studies would you use to check for suspected AKI?

A
  1. Ultrasound
  2. CT
  3. MRI/MRA
17
Q

What lab studies will you use to check for suspected AKI?

A
  1. Biochemical Tests (BUN/Creat)

2. Urinalysis (Electrolyres, Eosinophils)

18
Q

What interventions can be used in a patient with AKI?

A
  1. Fluid challenge

2. Foley catheter

19
Q

DDx for Prerenal Azotemia

A
  1. Etiology: Poor renal perfusion
  2. Serum BUN:Cr Ratio : > 20:1
  3. U(Na): 500
  4. Urinary Sediment: Benign or hyaline casts
20
Q

Fractional Excretion of Na+

A

(Urine (Na) / Plasma (Na)) / (Urine (Cr) / Plasma (Cr)) x 100%

21
Q

In pre-renal AKI, what are common characteristics that you will see in relation to the nephron?

A
  1. Decreased Blood Flow
  2. Decreased Excretion of Na and water
  3. Tubules conserve Na and water
22
Q

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)

A

About 7 days

23
Q

What does BUN stand for?

A

Blood urea nitrogen

24
Q

What does BUN test for?

A

Measures the amount of nitrogen in your blood that comes from the waste product urea.

25
Q

Where is urea made and what are the precursors?

A

Made in the liver and passed our through urine. Precursors are proteins in the body.

26
Q

What can cause an increased production of BUN?

A
  1. Amino Acid Infusion (TPN)
  2. Increased protein intake
  3. Steroids
  4. Catabolism
  5. GI Bleeding
27
Q

What does TPN stand for?

A

Total Paraenteral Nutrition

28
Q

How much of the urine excreted is urea?

29
Q

Creatinine Levels can change dependent on what factors?

A
  1. Sex (Men higher than women)

2. Age (Decreases as you age)

30
Q

This test measures the amount of plasma ultrafiltered across the glomerular capillaries and correlates with the ability of the kidneys to filter fluids and various substances.

A

Glomerular Filtration Rate

31
Q

This is a useful index of kidney function at the level of the glomerulus.

A

Glomerular Filtration Rate

32
Q

How can you measure GFR?

A
  1. Isotope (Iothalamate)
  2. Non-Isotope (Creatinine Clearance, Inulin Clearance)
  3. Estimation (Cockroft-Gault, MDRD GFR Equation)
33
Q

Crockroft-Gault Equation

A

Creatinine Clearance = ((140-age) x Weight (kg)) / Pcreatinine x 72

Be able to apply this on exam for a question!

34
Q

Classification and DDx for Post-Renal Azotemia

A
  1. Etiology: Obstruction of the Urinary Tract
  2. Serum BUN:Cr Ratio : > 20:1
  3. U(Na): Variable
  4. FENa(%): Variable
  5. Urine Osmolality: <400
  6. Urinary Sediment: Normal or red cells, white cells, or crystals

Nephrology (6 decks)

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