Acute Kidney Injury Flashcards
3 main categories of pre-renal AKI causes
- True intravascular fluid loss
Define renal AKI
Intrinsic renal failure
4 main categories of renal AKI causes
- Tubular
- Interstitial/Acute interstitialNephritis
- Glomerular
- Vascular
4 main categories of renal AKI causes (with examples)
Describe the mechanism of acute tubular necrosis (ATN).
- A drop in pressure/volume contraction decreases blood flow to the tubules
- High metabolic activity of PCT and TAL makes these epithelial cells very susceptible to ischemic and toxic injury when blood flow is insufficient.
Differences between pre-renal AKI and ATN
Etiology is the same for both, but ATN represents a more severe limitation to blood flow.
Pre-renal: Improving blood flow to kidney should improve the Cr and urine output.
ATN: Tubular damage has already occurred (it will take days-months to repair and recover).
Summarize the treatment for pre-renal AKI and ATN.
Volume expansion OR restoring volume to euvolemia (treat underlying condition - may differ from patient to patient).
What is a microscopic indication of ATN (that can help us confirm pre-renal vs ATN)?
Urine sediment of a patient with ATN will show dead tubule cells which form CASTS (muddy brown casts).
When is dialysis required for a patient with severe ATN?
- Falling urine output or anuria
- CHF
- Hyperkalemia
ATN prognosis
ATN usually improves, but healing and regenerating the tubular epithelial cells can take a long time, depending on the level of severity.
What is ascites?
Define rhabdomyolysis
Define multiple myeloma
Antibodies made by plasma chains…
What is Thrombotic Thrombocytopenic Purpura?
Which 4 structures of the urinary system can become obstructed? What is the consequence?
Obstruction of the urethra, prostate, bladder or ureters (both) will lead to post-renal AKI.
