acute kidney injury Flashcards
define
loss of kidney function with impairment of electrolyte and fluid balance and excretion of waste products
- creatine rise >26mmol in 48hr or 1.5x increase in baseline in 7 days
- urine output less than 0.5ml/kg/h over 6 consecutive hrs
symptoms
nausea and vomiting confusion dehydration oliguria sob odema fatigue hyper K , hypoNatr hyperglycemia due to phosphate retention
causes
pre-renal -> pancreatits, hypo and hypervol, NSAID/ACEi, COX2 inhibitor, ARB
D and V
burns
idione contrast agent
RF
over 65, male, south Asians and affricans hypertension diabetes pre-existing kidney disease recurrent UTIs heart failure liver disease
renal
glomerulitis, nephrotic syndrome, interstitial disease
post-renal
stones, BPH, malignancy
Ix
bloods- anaemia and esr- malignancy and myeloma
urine dipstick-haemturia and proteinuria
sodium urine
biopsy-interstitial disease
blood culture - exclude infection
ultrasound sonography-stones , dilatation
treatment
stop nephrotoxic drug
- treat cause
hypovol- 500ml crystalloid over 15 mins
hypervol-oxygen
renal replacement
fluid management and restrict K an Na intake
nephrostomy
cathetherise- flushing to remove obstruction
