Acute Kidney Injury and Chronic Renal Failure Lecture Powerpoint

Question 1

Acute Kidney injury is characterized by its ___

Answer 1

fast onset (days to weeks)

Question 2

Metabolic acidosis is brought on when the kidney is no longer doing what?

Answer 2

Excreting H+ ions and reabsorbing HCO3-

Question 3

2 values that confirm AKI

Answer 3

• increase in creatinine level

- decrease in urine output

Question 4

If a patient comes in with a higher creatinine but we don’t know if its their baseline, how do we determine?

Answer 4

Obtain old medical records

Question 5

1 risk factor for developing AKI is having…

Answer 5

Chronic kidney disease

Question 6

Mortality rate for severe AKI is up to ___%

Answer 6

60

Question 7

If AKI requires dialysis, there is a ___ risk of progression to CKD stage IV or V

Answer 7

Increased

Question 8

When treating AKI, important to avoid ____agents such as NSAIDS, aminoglycosides, ACE inhibitors/ARB’s, and cyclosporines

Answer 8

Nephrotoxic

Question 9

1 cause of prerenal AKI

Answer 9

Decreased renal perfusion

Question 10

1 cause of post renal AKI

Answer 10

Obstruction

Question 11

Prognosis of prerenal AKI

Answer 11

Good, typically does not cause permanent damage if treated

Question 12

Most common acute tubular necroses are in ____ patients

Answer 12

Hospitalized

Question 13

Acute Interstitial nephritis treatment (1)

Answer 13

-Corticosteroids

Question 14

Some common causes of Intrinsic AKI (4)

Answer 14

• glomerulonephritis
• acute tubular necrosis
• acute interstitial nephritis
• renal artery stenosis

Question 15

Common physical exam findings of AKI (5)

Answer 15

• edema
• confusion
• asterixis
• coke colored urine
• cva tenderness

Question 16

In assessing AKI you want to determine if it is prerenal or intrinsic renal, how can you do this?

Answer 16

FENa test <1% indicates prerenal cause and >2% indicates intrinsic renal cause

Question 17

Any patient having kidney issues needs to be on a ___ and ____restricted diet

Answer 17

protein, sodium

Question 18

Protective IV therapy against hyperkalemia for heart arrhythmia

Answer 18

Calcium gluconate

Question 19

Treatment for hyperkalemia to increase cellular uptake of potassium is…

Answer 19

….insulin with glucosee IV

Question 20

IV sodium bicarbonate can be used to treat….

Answer 20

….metabolic acidosis

Question 21

Indications that AKI warrants dialysis (3)

Answer 21

• metabolic acidosis
• hyperkalemia
• signs of uremia such as asterixis and mental decline

Question 22

1 cause of acute tubular necrosis is….

Answer 22

…renal hypoperfusion

Question 23

3 big hormones of the kidney

Answer 23

• calcitriol
• erythropoietin
• renin

Question 24

Chronic renal failure definition

Answer 24

Process of significant irreversible reduction in number of functioning nephrons characterized by at least 3 months of reduced GFR

Question 25

2 most common causes of chronic renal failure

Answer 25

• uncontrolled diabetes

- hypertension

Question 26

2 elements needed to diagnose chronic renal failure

Answer 26

• GFR

- Albuminuria

Question 27

6 stages of chronic renal failure

Answer 27

G1 - normal renal function >90mL/min
G2
G3a
G3b
G4
G5 - kidney failure, end stage renal disease, GFR <15ml/min

A1 normal to mildly increased albuminuria
A2
A3

Question 28

Chronic kidney failure in stage G1-G3B are usually ____

Answer 28

asymptomatic

Question 29

Chronic renal failure involves every organ system, including 2 endocrine ones…

Answer 29

…osteoperososis due to calcitriol lack and anemia due to erythropoietin

Question 30

Uremic scratching is a finding seen in ___ and define it

Answer 30

Chronic kidney failure, hyper phosphatemia causing itching and scratching on excoriated skin

Question 31

Treatment for chronic kidney failure includes these 4 classes of meds

Answer 31

• ACE or ARB’s
• diuretics
• Ereythropoietin stimulating agent
• iron supplements

Question 32

Because someone with CKD has a decline in blood flow to kidney, they may need a ___ dosage of lasix so it can perfuse to the loop of henle

Answer 32

increased