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SIU6 > AKI > Flashcards

AKI Flashcards

1
Q

name three things the kidney regulates?

A

pH via recreation and reabsorption of HCO3-
Osmolarity
Blood presssure

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2
Q

what does the kidney maintain?

A

ion balence

Na+ K+ ca2+ and HCl

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3
Q

what does the kidney excrete?

A

urea , creatinine, drugs , urobilinogen and hormones

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4
Q

what hormones does the kidney produce?

A

vitamin D3 and erythropoetin

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5
Q

how do you calculate the amount of solute excreted?

A

amount filtered - ( amount absorbed + amount secreted )

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6
Q

why is creating a useful indicator of eGFR?

A

It undergoes glomerular filtration in the kidneys and very little is reabsorbed. mainly excreted so useful indicator

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7
Q

what are two advantages of the Cockcroft and gault calc ?

A
  • easy to calculate on practise

- used for many years and so used in spa as a refernece

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8
Q

what are two disadvantages of the Cockcroft and gault calc ?

A
  • body weight isn’t an accurate measure of muscle mass so it cannot be used if a patient is obese
  • the calc is used on variable limits
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9
Q

what is an advantage of the MRDR equation?

A

a better estimation than cockcraft and Gault

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10
Q

what is an disadvantage of the MRDR equation?

A

Harder to calculate in practise

docent take into account the patients body mass

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11
Q

what is a negative of the CKD-EPI?

A

very complex to calculate

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12
Q

how does an AKI affect fluid balance?

A

oedema ( swollen legs) and pulmonary oedema can develop

diuretics may be needed

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13
Q

how does an AKI affect acid balance?

A

when a patient has pulmonary oedema and respiratory compensation acidity in the blood increases which can lead to hyper ventilation

Sodium retention increases leading to seizures and thirst

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14
Q

how does an AKI affect electrolyte balance?

A

electrolyte balance becomes disturbed which can cause arrithhymias , muscle weakness and paralyis.

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15
Q

what happens to endocrine function in an AKI

A

erythropoetin production can be reduced leading to anemia this is more common in CKD than an AKI

vitamin d activation is reduced leading to an increased risk of fractures

renin agiotensin system is reduced leading to calcification in blood vessles and an increased cardiovascular risk

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16
Q

how does an AKI affect excretion?

A

patient has reduced excretion of

  • water soluble substances leading to pruritus , itching cramping and restless leg syndrome
  • waste products leading to nausea and toxicity and due to increased acidity ulcers
  • medication leading to drug toxicity
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17
Q

what is an AKI?

A

a sudden decline in kidney function over hours or days , not a disease or a physical injury

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18
Q

why does acidosis happen during an AKI ?

A

as there is disruption of acid base balance

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19
Q

why doses oedema happen during an AKI?

A

disruption of the fluid balance

20
Q

why do cardiac arrhythmias , muscle weakness and paralysis occur during an AKI?

A

disruption go the regulation of electrolytes which causes hyperkalemia

21
Q

what are the pre renal causes of an AKI ?

A

hypo-perfusion
kidney cells being killed
acute tubular necrosis
blood going into the kidney and having a low bp

22
Q

what are the renal causes of an AKI ?

A

intrinsic renal disease

23
Q

what are the post renal causes of an AKI?

A

obstruction something is blocking urine output

24
Q

what are the causes of kidney failure?

A

pyelonephritis , hypertension, diabetes mellitus , nephrotoxic drugs ,hypoyvelemia and nephroallergens

25
Q

how can phylonephriitis cause an AKI?

A

it is inflammation and detonation of the phenols due to infection antigens

26
Q

how can hypertension cause an AKI?

A

chronic overloading of the kidney with fluid and electrolytes may lead to kidney insufficiency and failure.

27
Q

how can diabetes cause an AKI?

A

disturbance of sugar and the acid base balance may lead to renal disease

28
Q

how can nephrotoxic drugs cause an AKI?

A

some dugs taken chronically can cause irreversible kidney damage

29
Q

how can hypovelemia cause an AKI?

A

reduction in renal blood flow will lead to schema and damage

30
Q

how can nephroloallergens cause an AKI?

A

some compounds produce an immune reaction type of sensitivity reaction with nephritic syndrome

31
Q

which drugs in particular are nephrotoxic ?

A

ahminoglycosides , phenacetin and heavy metals.

32
Q

what is uraemia?

A

it is chronic or acute kidney failure causing impaired glomerular filtration caused by disease or trauma

33
Q

what are the pharmacokinetic considerations ?

A 
oral bioavalibility 
elimination 
volume of distribution
dose considerations 
total body clearance
34
Q

how is oral bioavailability affected in the pk considerations of a uraemia patient?

A

oral bioavalibility may decrease but drugs with a high first pass effect increase bioavalibility

35
Q

how is elimination affected in the pk considerations of a uraemia patient?

A

elimination clearance increases which reduces glomerular filtration

36
Q

how is total body clearance affected in the pk considerations of a uraemia patient?

A

it is reduced

37
Q

how is volume of distribution affected in the pk considerations of a uraemia patient?

A

-protein binding decreases so the amount of free unbound drug increases
- accumulation of metabolites decreases especially weak bases
-changes in total body water
Overall Vd increases

38
Q

what is dialysis?

A

the diffusion of molecules from the patients blood into the dialysis fluid through a membrane until an equilibrium, can be reached

39
Q

what are the factors affecting dialyisis?

A

protein binding
molecular weight
volume of distributon
water soluble

40
Q

how does water solubility affect dialysis ?

A

drugs that are fat soluble are not dialysis

41
Q

what is peritoneal dialysis?

A

filters through the patients own peritoneal membrane in there abdomen

42
Q

what is haemodialysis ?

A

uses an artificial membrane to filter through

43
Q

how does molecular weight affect dialysis ?

A

drugs under 500 MW are dialysed easily

44
Q

how does protein binding affect dialysis ?

A

drugs that are tightly bound to proteins aren’t dialyses easily as dialysis is a passive process

45
Q

how does volume of distribution affect dialysis ?

A

drugs that have a volume of distribution take longer to be hydrolysed

46
Q

what is hemoperfusion?

A

when the blood passes through an absorbent material and goes back into the patients body

47
Q

what is haemofiltration

A

when fluids electrolytes , small molecules are removed from the body by low pressure flow through hollow artificial fibres

SIU6 (11 decks)

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