Acute Renal Failure - 227 Flashcards
Pre-renal AKI is due to what?
Altered haemodynamics.
In pre-renal AKI is there cellular injury?
No - renal function will normalise with reversal of the altered hemodynamics
How can third space sequestration cause kidney injury?
It results in increased abdominal pressure which can compromise renal blood flow. Oliguric renal failure
Post - renal AKI can be put into 3 categories - what are they?
Intrinisc
Extrinsic
Lower obstruction
Intrinsic AKI causes what? What is it? (Aeitology etc)
Acute tubular necrosis, the most common intrinsic AKI (85%). Tubular injury can be nephrotoxic (rhab, drug induced) or ischemic (hypotension etc)
What is the 3rd highest cause of hospital acquired AKI?
Radiocontrast nephropathy
What is acute tubulo-interstitial nephritis? What can cause it?
Intrinsic AKI, can be drug induced or infection related
What drugs can cause acute tubulo-interstitial nephritis?
Penicillins
Cephalosporins
Sulfonamides
Rifampicin
What is the normal serum anion gap?
6-13
What drug is given in hyperkalaemia? Why?
Ca gluconate, it is cardioprotective
IV dextrose solution does what to K?
Shifts K to the intracellular compartment
Give 3 non-traumatic causes of rhabdomyolysis
Marathon runners
Heat
Hypokalaemia
Alcohol
What ion is essential for maintaining muscle perfusion during exercise?
K
What are 3 signs seen in rhabdomyolysis?
1) Red/brown urine due to pigmented casts
2) Elevated serum enzymes, CK and LDH
3) Electrolyte abnormalities - Hyperkalaemia, hyperphosphataemia , hypocalcaemia
What happens to calcium levels in the recovery phase of rhabdo?
You get hypercalcaemia as Ca is released from the damaged muscle
