Acute Kidney Injury Flashcards
Define AKI
Syndrome of falling GFR
Diagnosis of AKI
serum creatinine ≥26.5
Stage 1 AKI
Stage 2
stage 3
Urine output
creatinine rise ≥26.5
Cortex receives how much blood
Most /80%
What’s in cortex and what’s it at risk of
proximal tubular cells are very susceptible to hypotension and hypoxia
Classification of AKI
pre renal
Intrinsic
Post renal
Name pre renal causes of AKI
Volume depletion
Decrease effective volume
Altered intrarenal haemodynamics
Cause of intrinsic AKI
Acute tubular necrosis
Acute
Glomerulonephritis
Accurate interstitial nephritis
Hyperkalaemia is
Increased K+
Normal K+
3.5 mol/l
At 5.5 + what do you see on ECG
Peaked T wave
Prolonged PR segment
6.5 K+ what do you see
Loss of P. Wave
Prolonged QRS
ST elevation
Eptopic beats
Above 8 k+ you see
Progressive widening of QRS Sine wave Bundle of his blocks Ventricular fibrillation Fascicular blocks
Metabolic acidosis ABG and symptoms
pH < 7.3 pCO 2 pO 2
HCO
3
low normal to high low
Symptoms
breathless / tachypnoeic nausea non-specifically unwell
Uraemia is
Retention of metabolic waste products
Uraemia causes what condition which is what
Pericarditis
Which makes pericardium inflamed
What % of ICU patients have AKI
57% very common
Management of AKI
Exclude life threatening condition
Identify aetiology of AKI
Supportive treatment
Avoidance of progression
RRT IS
Renal replacement therapy
How does RRT work
Blood from patient pumped then effluent produced where water and electrolytes taken out.
Then through air detector
Then back into patient
Vascular access for RRT
inter jugular vein
Femoral vein
Subclavian vein