Acute Kidney Injury (AKI) Flashcards
What is AKI?
An acute drop in kidney function
What is the criteria for AKI diagnosis?
Rise in creatinine of ≥ 26.5 micromol/L in 48 hours
Rise in creatinine baseline by 1.5 times in 7 days
Urine output of < 0.5ml/kg/hour for > 6 hours
What is stage 1 AKI?
1.5-1.9 times baseline or >26.5 micromol increase
<0.5ml/kg/hr urine out put for 6-12 hours
What is stage 2 AKI?
2.0-2.9 times baseline
<0.5ml/kg/hr urine out put for >12 hours
What is stage 3 AKI?
3.0 times baseline or initiation of RRT
<0.3ml/kg/hr urine out put for >25 hours or anuria for >12 hours
What risk factors predispose to AKI?
Chronic kidney disease
Heart failure
Diabetes
Liver disease
Older age (above 65 years)
Cognitive impairment
Nephrotoxic medications such as NSAIDS and ACE inhibitors
Use of a contrast medium such as during CT scans
What are pre-renal causes of AKI?
Inadequate blood supply to kidneys:
- Dehydration
- Hypotension
- Heart failure
- Sepsis
- Haemorrhage
- Burns
- Drugs
- MI
What are renal causes of AKI?
Intrinsic disease in the kidney:
- Glomerulonephritis
- Interstitial nephritis
- Acute tubular necrosis
- Vasculitis
- Rhabdomyolysis
What are the post renal causes of AKI?
Obstruction to outflow of urine (obstructive uropathy):
- Kidney stones
- Tumour
- Ureter strictures
- Enlarged prostate
- Prostate cancer
What investigations are carried out for AKI?
Bloods
Urine dipstick
Protein quantification
Immunology tests
Ultrasound
What is involved in urinalysis?
Protein and blood- acute nephritis
Leucocytes and nitrites- infection
Glucose- diabetes
What is the management of AKI?
IV fluid rehydration in pre renal AKI
Stop nephrotoxic meds such as NSAIDS and ACEIs
Relieve obstruction in post-renal AKI e.g. catheterisation
What are the complications of AKI?
Acidosis
Electrolyte imbalance- hyperkalaemia
Intoxication toxins
Overload
Uraemic complications
What are some treatment options for hyperkalaemia?
IV calcium gluconate
Salbutamol
Insulin dextrose
Diuresis
Dialysis
K+ binders
