Acute Kidney Injury Flashcards
how quickly does an AKI occur
in <48hr
which drugs are risk factors for AKI
contrast, ACEI, ARB, NSAID, metformin, genta, trimethoprim, diuretic
what is a stage 1 AKI
Cr >26 OR >1.5-1.9X baseline
or
UO <0.5/hr for >6hr
what is a stage 2 AKI
Cr >2X baseline
or
UO <0.5/hr for >12hr
what is a stage 3 AKI
Cr>3X baseline or >354 or need RRT or UO <0.3/hr for >12hr
how are the causes of AKI classified
pre-renal, renal, post-renal
causes of pre-renal AKI
decrease blood volume, decreased blood pressure, hypoperfusion e.g. shock
causes of renal AKI
acute tubular necrosis, GN, acute interstitial nephritis, small vessel vasculitis
causes of acute tubular necrosis
drugs, uraemia, ischaemia from pre-renal, hepatorenal synd, rhabdomyolysis
what drugs can cause acute tubular necrosis
NSAID, ACEI, contrast, genta
causes of acute interstitial nephritis
TB, SLE, sarcoid, drugs, pyelonephritis
what drugs can cause acute interstitial nephritis
PPI, fluclox hypersensitivity, NSAID
causes of post-renal AKI
obstruction e.g. stircture, tumour, stone
what types of shock can cause pre-renal AKI
distributive, cardiogenic
what electrolyte disturbance is caused by rhabdomyolysis
hyperkalaemia
what is the 1st thing to do in suspected AKI
stop nephrotoxic drugs, diuretics, and antihypertensives
investigations for AKI
bloods, urinalysis, US kidney
what blood tests for AKI
U+E, FBC, Hb, bicarb, coag screen
what tests should you do if urinalysis is positive
ANA, ANCA, complement, UPCR
what can you get from renal US in AKI
can see hydronephrosis, and size/scarring helps determine if pre-existing renal disease
what are the red flags for myeloma
> 50 yr + anaemia + hypercalcaemia