acute kidney injury Flashcards
what are immediately dangerous consequences of AKI?
acidosis, electrolyte imbalance
intoxication
overload
uraemic complications
what is mortality of AKI like for different stages?
2% no AKI
8% AKIN 1
25% AKIN 2
33% AKIN 3
what are the three different categories of causes for AKI?
pre-renal
intrinsic
post renal
what are exmaples of pre renal causes?
cardiac failure
haemorrhage
sepsis
vomiting and diarhoea
what are examples of intrinsic causes?
glomerulonephritis
vasculitis
radiocontrast
myeloma
rhabdomyolysis
drugs
what are examples of post renal causes?
tumours
prostate disease
stones
much of AKI is avoidable what should you try to prevent?
avoid dehydration, nephrotoxic drugs
reveiw clinical status of those at risk
hold medication, give fluids, treat sepsis
what are medicine sick day rules?
if you are unwell with vomiting, diarrhoea, fever, sweats, shaking then stop taking
ACE, ARBS, NSAIDS, diuretics, metformin
restart when you are well
how should you respond to AKI?
AKI e alerts
nice guidelines
what are potential indications for RRT?
acidosis
electrolyte imbalance
intoxication
overload
uraemic complications
what are ecg changes seen in hyperkalaemia?
peaked t waves
tall tented t waves
p wave widens and flattens
pr segment dissapears
p waves eventially dissapear
prolonged qrs interval
high grade av block
conduction block
sinus bradycardia or slow af
a sine wave appearance
CARDIAC ARREST
how is hyperkalaemia treated
stablise myocardium
calcium, gluconate
shift K+ intracellularly
salbutamol
insulin dextrose
remove
diuresis
dialysis
anion exchange resins
