Acute Kidney Injury Flashcards
what is an acute kidney injury?
A sudden decline in function & rapid progressive
is an acute kidney injury reversible?
it can be
what labs would you find with an acute kidney injury
decreased GFR so <90
decreased uOP so <30 mL/ hour, or <400 mL/day
increased BUN so >20
Increased creatinine so >1.2
what does AKI often follow?
severe, prolonged hypotension, hypovolemia, or exposure to nephrotoxic agents
what is the most common cause of pre-renal AKI
decreased cardiac output, so hypotension, hypovolemia, decreased perfusion to kidneys
what is the most common cause of intrarenal AKI
acute tubular necrosis
what is an example of a post renal AKI
BPH (benign prostatic hypertrophy)
what are the clinical manifestations for aKI
- 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
Treatment for aKI
Correct fluid and electrolyte imbalances, especially hyperkalemia and excess fluid volume
- manage BP
- prevent/treat infections
- maintain nutrition
- avoid nephrotoxic drugs
how to lower serum potassium?
- 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
when should you NOT give sodium polystyrene sulfonate (kayexalate)
- do not use for emergency life threatening hyperkalemia due to delayed onset
- do not give if paralytic ileus
who is going to KILL this exam?
ALL OF US
