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Renal > acute kidney injury > Flashcards

acute kidney injury Flashcards

1
Q

what is AKI?

A
  • Abrupt decline in kidney function
  • characterised by:
    1. increase serum creatinine and urea
    2. decrease in urine output
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2
Q

what are the risk factors for AKI?

A
  • increasing age
    -comorbidities- T2DM, CHF, HTN
    -Hypovolemia
  • nephrotoxic drugs
  • trauma
  • cancer
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3
Q

what are the three TOP causes of AKI?

A
  1. sepsis
  2. cardiogenic shock
  3. major surgery
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4
Q

What are the three types of causes of AKI?

A
  1. Pre -renal
  2. renal
  3. post renal
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5
Q

name some examples of pre renal AKI

A

Hypoperfusion
- low blood volume - shock, CHF, bleeding, dehydration
- liver failure
- renal artery stenosis
- drugs- NSAIDs or ACE-i

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6
Q

name some examples of renal AKI

A

nephron + parenchymal damage
- glomerulophritis
- necrosis
- acute interstitial nephritis
- tubular
-toxins

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7
Q

name some examples of post renal AKI

A

obstructive uropathy
- stones
- prostate enlargement- BPH, cancer
- occluded indwelling cancer
- drugs

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8
Q

what is the pathology behind AKI?

A
  • Accumulation of usually excreted substances - this is what causes the symptoms
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9
Q

what are the signs for AKI?

A
  • Hyperkalaemia
  • Hyperuremia
  • Fluid overload - Oedema
  • acidosis
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10
Q

what does hyperkalaemia cause in AKI?

A
  • Arrhythmias
  • muscle weakness
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11
Q

what does hyepruremia cause in AKI?

A
  • nausea and vomiting
  • weakness
  • pericarditis
  • bleeding
  • pruritus
  • uremic frost
  • confusion if severe
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12
Q

what does fluid overload cause in AKI?

A
  • pulmonary and peripheral oedemas
  • hypovolemic shock
  • decreased urine
  • palpable bladder
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13
Q

what does AKI cause?

A
  • metabolic acidosis
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14
Q

what does an ECG for hyperkalaemia look like?

A
  • tall tented T waves
  • wide QRS
  • flat P waves
  • prolonged PR interval
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15
Q

what is the best way to differentiate between the different types of AKI?

A

if U: Cr > 100 : 1- pre- renal
< 40 : 1 - renal
40-100: 1 - post renal

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16
Q

how is AKI diagnosed?

A
  • KDIGO classification
  • U+E
  • Renal biopsy
  • FBC + CRP
  • Renal USS
17
Q

describe the KDIGO classification for AKI?

A
  • serum creatine- increase of 26 micro mol/L within 48hrs ( needs baseline)
    or
  • 1.5 x baseline for 7 days
    or
  • urine output < 0.5 ml/kg/hr for > 6 hrs
18
Q

What would U + E tell you for AKI?

A
  • K+, H+, Urea, Creatine
19
Q

what would your FBC and CRP tell you for AKI?

A
  • infection
20
Q

when would you do a renal biopsy for AKI?

A
  • for intrarenal cause
21
Q

What is the treatment for AKI?

A
  • treat underlying cause- Hypotension, infection, stones and obstruction
  • treat underlying complications
  • stop drugs
22
Q

if AKI is severe, how should you treat?

A

dialysis ( RRT)

Renal (14 decks)

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