AKI Flashcards
1
Q
Risk Factors for AKI
A
- Age > 65 years old
- African American ethnicity
- diabetes
- CKD
- nephrotoxin use
- decreased effective circulatory volume
2
Q
Staging of AKI:
1_____
2____
3____
A
1: 1.5-1.9 x baseline
2: 2.0-2.9 x baseline
3: 3.0 x baseline
3
Q
What biomarkers are increased in functional changes of kidney injury?
A
- SCr
- BUN
4
Q
What is kidney damage?
A
-presence of glomerular and/or tubular injury
5
Q
What are some general preventions of AKI?
A
- maintain euvolemic and normal electrolytes
- maintain organ perfusion
- avoid nephrotoxins (aminoglycosides, amphotericin, iodine contrast, vancomycin etc..)
6
Q
What are some preventions that can be used in contrast induced AKI?
A
- isotonic, sodium containing crystalloids
- sodium bicarb (potential for harm)
- N-acetylcesteine (shows no benefit)
- vitamin C
7
Q
Treatment of Hemodynamic AKI
A
- intravascular volume repletion (urine goal: >0.5 ml/kg/hr
- temp hold: ACEi, ARBs, NSAIDs, SGLT2i & calcineurin inhibitors
- restart once kidney function returns to normal*
8
Q
Treatment of Pre-renal AKI
A
- intravascular volume repletion (urine goal: >0.5 ml/kg/hr
- temp hold of loop diuretics and thiazide diuretics
9
Q
How do you diagnose Pre-renal AKI
A
FeNa <1% or Fe Urea <35% if on loop diuretics
10
Q
What do you do if intrinsic AKI is caused by a medication?
A
STOP the medication and do not re-start it; list it as an ALLERGY
11
Q
What is the treatment of post-renal AKI?
A
****relieve obstruction! Acute: foley catheter, nephrostomy tube Chronic: *treat underlying cause* --> BPH: finasteride -->cancer-chemotherapy, radiation, surgical removal
