AKD Flashcards
SEVERITY
- asymptomatic
- fatal
- sudden
- Renal function
- Retention of nitrogenous wastes
AKD
duration of AKD
- acute
- chronic
Categories of Acute Kidney Injury
- Hypovolemia
- Decreased cardiac output
- Decreased effective circulating vol
+ Congestive heart failure
+ Liver failure - Impaired renal autoregulation
+ NSAIDs
+ ACE-VARB
+ Cyclosporine
PRERENAL
Categories of Acute Kidney Injury
INTRARENAL
- Glomerular
+ Acute glomerulonephritis - tubules and interstitium= sepsis/ infection, ischemia, Nephrotoxins
- Vascular
+Vasculitis
+ Malignant hypertension
+ TTP-HUS
Categories of Acute Kidney Injury
POSTRENAL
- Bladder outlet obstruction
- Bilateral pelvoureteral obstruction (or unilateral obstruction of a solitary functioning kidney)
Factors that affect the autoregulatory response:
- Atherosclerosis
- Age
- long standing hypertension
- SBP <80 mm Hg
narrowing and
impaired vasodilation
Hyalinosis and myointimal
hyperlasia
ecreased perfusion pressure in the presence of NSAIDs
- Decreased vasodilatory prostaglandins
- increased angiotensisn II
creased perfusion pressure in the presence of ACE-I or ARB
- slightly increased vasodilatory prostaglandins
- decreased angiotensin II
- Arterial vasodilation in the splanchnic circulation despite volume overload
- Reduced systemic vascular resistance
- Vasoconstriction: Hypovolemia
HEPATORENAL SYNDROME
perturbations in the microcirculation
occlusion of small vessels
HYPOXIA
directly
generation of free radicals
CYTOTOXIC DAMAGE
Nephrotoxins: Antibiotics
Exogenous:
high trough levels
Vancomycin
Nephrotoxins: Antibiotics
Exogenous:
both cause tubular necrosis
(vasoconstriction and direct tubular injury)
Aminoglycosides & Amphotericin B
Nephrotoxins: Antibiotics
Exogenous:
tubular obstruction
Acyclovir
Nephrotoxins: Antibiotics
Endogenous
- intrarenal vasoconstriction,
- direct proximal tubular toxicity
- mechanical obstruction
- Intratubular crystals
Intrinsic: Glomerulonephritis
- glomerular podocytes
- mesangium
- endothelial cells
Where is WBC cast found in urinary?
Distal
Where is Epithelial cell cast found in urinary?
Distal