Acute Kidney Injury Flashcards
What is uraemia?
When nitrogenous metabolic waste products accumulate in blood (e.g creatinine and urea)
Why do levels of creatinine and urea rise rapidly in AKI?
Poor clearance of these substances by the kidneys
What is acute kidney injury?
Deterioration of renal function over hours or days
What are three dangerous consequences associated with AKI?
Volume overload, hyperkalaemia, and metabolic acidosis
How is the staging of AKI severity determined?
Creatinine levels compared to normal baseline
Stage 1: 1.5-1.9 times higher
Stage 2: 2-2.9 times higher
Stage 3: 3-3.9 times higher
What are the three types of causes of AKI?
Pre-renal, intrinsic renal and post renal
What medications can predispose the kidney to pre-renal AKI?
NSAIDS and ACE inhibitors, as these impair the renal autoregulation mechanisms
What things can cause post renal AKI?
Tumours, stones, urethral strictures, BPH
How would you investigate for AKI?
Urine tests, blood tests, renal imagining
In the biochemical changes that occur following AKI which substances will increase in their plasma concentrations?
Urea, creatinine, irate, potassium, phosphate
Following AKI which chemicals can there be a decrease in?
Sodium, calcium (due to rise in phosphate)
Which of the three categories of AKI would be indicated in a patient with history of: Thirst, weight loss, on diuretics. And signs of: low BP with postural drop, elevated pulse and low JVP
Pre-renal
Which of the three categories of AKI would be indicated in a patient with history of: exposure to toxic agents, hypertension
Intrinsic renal AKI
Which of the three categories of AKI would be indicated in a patient with history of: frequency, hesitancy. And on examination find an enlarged prostate?
What is the most likely cause?
Post renal AKI
Most likely BPH or tumour of the prostate
How would you manage a patient with pre-renal AKI?
Treat hypovolaemia with fluids, correct any electrolyte imbalances
