AKI

Question 1

What are the risk factors?

Answer 1

Diabetes
CKD
IHD/CCF/CVD
Over 75
Sepsis
Medications - ACEi, ARB, NSAID, Abx

Question 2

What are the pre-renal causes?

Answer 2

Hypovolemia
Hypoperfusion
Sepsis
Shock

Question 3

What are the renal causes?

Answer 3

Acute tubular necrosis
Acute interstitial nephritis
Glomerular disease
Vascular disease

Question 4

What are the post-renal causes?

Answer 4

Bladder outflow obstruction
Tumour
Stone
Retroperitoneal fibrosis causing ureteral obstruction

Question 5

What are the investigations?

Answer 5

Urine dipstick
Daily FBC, U+Es, LFTs, bone profile, CRP
If blood and protein on dipstick, perform c-ANCA and p-ANCA for vasculitis and antibodies

Question 6

What is the management?

Answer 6

Discontinue nephrotoxic agents if possible
Ensure volume status and perfusion pressure - if dehydrated give IV fluids, if overloaded give diuretics
Monitor urine output and daily bloods
Treat underlying cause

Question 7

What are the complications?

Answer 7

Hyperkalaemia
Hyperphosphataemia
Uraemia
End-stage renal disease

Question 8

How is hyperkalaemia treated in AKI?

Answer 8

Calcium gluconate
Low K+ diet
Salbutamol nebuliser
Oral/IV bicarbonate
Calcium resonium