Acute kidney injury (AKI) Flashcards

1
Q

What is the current definition of AKI

A

Increase in serum creatinine by at least 26.5 micromol/litre within 48 hours
or to increase their baseline by 1.5 times within the 7 days prior

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2
Q

Describe AKI stage 1

A

1.5-1.9x the baseline
more than or equal to 26.5 micromol/Litre increase in serum creatinine
Urine output<0.5 ml/kg/hour for 6 hours

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3
Q

Describe AKI stage 2

A

2-2.9x the baseline
urine output<0.5 for at least 12 hours

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4
Q

Describe AKI stage 3

A

3x the base line
Serum creatinine increase to at least 354micromol/l
Or initiation of RRT - renal replacement therapy
urine output <0.3mg/kg/hour for more than 24 hours or anuria for more than 12 hours

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5
Q

What are the immediate dangerous consequences of AKI

A

AEIOU
A - acidosis
E - electrolyte imbalance
I - intoxication (toxins)
O - overload
U - uraemic complications

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6
Q

What are the types of causes of renal failure

A

Pre-renal - most common

Intrinsic

Post-renal

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7
Q

What are pre-renal causes of AKI

A

Anything that alters the blood supply to the kidney e.g hypovolaemia, hypertension, sepsis…

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8
Q

What are post renal causes of AKI

A

After the kidney so normally affecting the outflow of urine therefore: tumours, prostate disease and calculi (stones)

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9
Q

What are intrinsic causes of AKI

A

Within the kidney like glomerulonephritis and vasculitis

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10
Q

What are steps taken to prevent AKI

A

S - sepsis - test for sepsis because it increases risk of AKI
T - toxins
O - optimise BP
P - prevent harm - maintain fluids and medication

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11
Q

What is done to review AKI

A

BUMP
B - Bloods
U - ultrasound
M - medication
P - plan for fluid maintainence

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12
Q

When is RRT indicated

A

If no treatment is working for the AKI and stopping the initial cause of the AKI is not helping either

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13
Q

What are changes to an ECG when there is hyperkalaemia

A

Peaked T waves
P waves begin to lengthen and flatten out and the PR segment becomes longer
Eventually the P waves disappear
Can cause:
cardiac arrest
asystole
ventricular fibrillation
Any kind of conduction block
bradycardia

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14
Q

What is the treatment for hyperkalaemia - to stabilise the myocardium

A

calcium gluconate

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15
Q

What is the treatment for hyperkalaemia - to shift the potassium back into the cell

A

Salbutamol neubulisers, insulin and dextrose - push potassium back into the cell

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16
Q

What is the treatment for hyperkalaemia - to remove the potassium

A

Diuresis
Dialysis
Binders - lokelma

17
Q
A