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Acute Care and Trauma > Acute Kidney Injury/Acute Renal Failure* incomplete > Flashcards

Acute Kidney Injury/Acute Renal Failure* incomplete Flashcards

1
Q

Definition of acute renal failure and acute kidney injury?

A

Impairment of renal function over an acute period (days/weeks)
- acute kidney injury represents the full spectrum of acute kidney dysfunction

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2
Q

What are the 3 types of acute renal failure?

A

Pre-renal
Renal
Post-renal

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3
Q

What is the general cause of pre-renal acute renal failure, and what are some examples? (1 + 2)

A

Reduced renal perfusion

  • Shock (hypovolaemic, septic, cardiogenic)
  • hepatorenal syndrome (liver failure)
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4
Q

What is the main cause of renal acute renal failure we need to know? (1)

A

Acute glomerulonephritis

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5
Q

What are the primary and secondary (causes of causes!) causes of renal acute renal failure? (5)

A
  • Acute tubular necrosis (ischaemia, drugs and toxins)
  • Acute glomerulonephritis
  • Acute interstitial nephritis (drugs)
  • Small/large vessel obstruction (renal artery/vein thrombosis, cholesterol emboli, vasculitis, haemolytic microangiopathy)
  • Others (Ig light-chains in multiple myeloma, urate, pigment nephropathy from haemolysis/malaria)
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6
Q

What are the primary causes of post-renal acute renal failure? (4)

A
  • Stones
  • Tumours (pelvic, prostate, bladder)
  • blood clots
  • retroperitoneal fibrosis
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7
Q

Presentation of acute renal failure? (7 + 1)

A 
Malaise
Anorexia
Nausea
Vomiting
Pruritis
Drowsiness
Convulsions
Coma (uraemia-specific)
- symptoms of the cause or complications usually dominate
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8
Q

Examination findings in acute renal failure? (2)

A

Oedema

Signs of the cause/complications

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9
Q

Viable investigations in acute renal failure? (6)

A
  • Bloods
  • Urinalysis
  • Imaging
  • ECG
  • Renal biopsy
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10
Q

What basic bloods are indicated in acute renal failure? (5)

A 
FBC
U&Es
LFTs
ESR/CRP
Ca2+
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11
Q

What more specific bloods are indicated in acute renal failure and why? (2)

A

CK - rhabdomyolysis

Urate - uraemia

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12
Q

Other than basic blood testing, what investigations involving blood are indicated in acute renal failure? (5)

A
  • ABG
  • Cultures
  • Clotting screen (PT, APTT)
  • Blood film
  • Serum electrophoresis and autoantibodies
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13
Q

What urine tests are indicated in acute renal failure? (4)

A

Dipstick
Microscopy
Culture and sensitivity
Urine osmolality/Na+

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14
Q

What types of imaging are indicated in acute renal failure and why? (2)

A

CXR - monitor for fluid overload (pulmonary oedema)

Renal US - exclude an obstructive cause

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15
Q

Why use ECG on acute renal failure and what could you see? (1)

A

Checks for hyperkalaemia (tented T-waves)

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Acute Care and Trauma (1 decks)

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