Acute Kidney Injury

Question 1

What are the clinical features of AKI?

Answer 1

1. Oliguria or anuria
2. Uraemia (xs urea/protein in blood)
3. Nausea vomiting
4. Anorexia
5. Confusion

Question 2

On AKI what are the consequences of fluid retention?

Answer 2

1. Peripheral oedema

2. SOB (pulmonary oedema/pleural effusions)

Question 3

In AKI what are the consequences of volume depletion?

Answer 3

1. Postural hypotension

2. dehydration

Question 4

What can cause AKI?

Answer 4

1. Drug hypersensitivity
2. Rhabdomyolysis (muscle pain/heroin abuse)
3. Goodpasture’s syndrome (dyspnoea,hemoptysis)
4. Malignant hypertension or diabetes
5. Hepatorenal failure (jaundice, stigmata of the liver)

Question 5

How is AKI classified?

Answer 5

Clinically AKI is characterized by a rapid reduction in kidney function resulting in a failure to maintain fluid, electrolyte and acid base homeostasis.

Question 6

What is the definition of AKI?

Answer 6

1. Serum creatinine rises by >=26micromol/l within 48 hours or
2. Serum creatinine rises>= 1.5 fold from the reference value, within one week
3. Oliguria <0.5ml/kg/hr>6 consecutive hrs or
4. 25% or > fall in eGFR in kids/young people in 7 days

Question 7

What are the causes of AKI?

Answer 7

1. Pre renal
2. Renal
3. Post renal

Question 8

What are the pre renal causes of AKI?

Answer 8

1. Hypovolaemia (acute hemorrhage, burns)

2. Circulatory failure (heart failure, shock)

Question 9

What are the renal causes of AKI?

Answer 9

1. Acute tubular nephropathy ( ischaemic acute tubular necrosis)
2. Acute interstitial nephropathy ( ascending urinary tract uti)
3. Acute glomerulonephritis Goodpasture’s syn
4. hemolytic uremic syndrome
5. Cytotoxic drugs (cisplatin streptozotocin, aminoglycosides such as gentomicin, NSAIDS, ACEs)
6. Malignant hypertension
7. Multiple myloma
8. Hepatorenal syndrome

Question 10

What are the post renal causes of AKI

Answer 10

1. Stones
2. Prostatic hypertrophy
3. Congenital obstructive disorders