Acute Kidney Injury (AKI) Flashcards
Define acute kidney injury (AKI).
Acute kidney injury was previously known as acute renal failure (ARF). It is characterised by an ACUTE DECLINE IN RENAL FUNCTION. This leads to an increase in serum creatinine and a decrease in urine production/outflow.
Explain the aetiology/risk factors of acute kidney injury (AKI).
Sepsis
Cardiovascular collapse
Congestive heart failure
Major surgery
Nephrotoxins (such as antibiotics, intravenous contrast, or other drugs)
Urinary outflow obstruction
Summarise the epidemiology of acute kidney injury (AKI).
Among people hospitalised in 2014 with AKI, 40% also had diabetes.
In the intensive care unit (ICU), the incidence of AKI is higher.
Acute tubular necrosis (ATN) accounts for 45% of cases of AKI.
Recognise the presenting symptoms of acute kidney injury (AKI). Recognise the signs of acute kidney injury (AKI) on physical examination.
Flank pain
Haematuria
Oedema
Lethargy
Uraemia
Decreased urine output
AKI can be asymptomatic and is usually defined by lab tests.
Identify appropriate investigations for acute kidney injury (AKI) and interpret the results.
Basic metabolic profile (including urea and creatinine). Ratio of serum urea to creatinine.
Urinalysis.
Urine culture
FBC
Fractional excretion of sodium
Fractional excretion of urea
Urinary eosinophil count
Venous blood gases
Fluid challenge
Bladder catheterisation
Urine osmolality
Urine sodium concentration
CXR, ECG
Generate a management plan for acute kidney injury (AKI).
Treat the underlying cause
Identify the possible complications of acute kidney injury (AKI) and its management.
- Hyperkalaemia
- Heart failure
Give calcium gluconate to stabilise the myocardium. Then give a bolus of insulin with 20% dextrose, 100ml. - Uraemia
- Metabolic acidosis
Give dialysis.
Summarise the prognosis for patients with acute kidney injury (AKI).
Recovery for AKI is variable and depends on the cause of injury and the severity and duration of AKI.
