AKI Flashcards
Labs of AKI
Decreased GFR
Increased BUN / Cr
Azotemia
accumulation of nitrogen waste products and an abrupt increase in BUN
3 causes of AKI
Prerenal - Reduced blood flow
Renal - Directly on glomeruli or renal tubules
Post Renal - Obstruction (Nephrolithiasis, BPH)
Nephrotoxic Meds
Aminoglycosides
Penicillins
Amphotericin B
Cephalosporins
Tetracyclines
Sulfonamides
Furosemide
Methotrexate
Methyldopa
Rifampin
Spironolactone
Thiazide Diuretic
Carbamazepine
AKI initiation phase
occurs at time of insult for several hours to up to 2 days.
reversible
Tx; Prevention, fluids, antidysrhythmics
AKI Oliguric/ Anuric phase
Damage to tubular wall
BUN and Cr increase
Tx: Renal overload, electrolyte imbalances
Increased K, P, Mg
Decreased Na, Ca
AKI Recovery
Increased in U/O
Monitor fluid and electrolyte balances
Return of tubular function
4-6 months for BUN/Cr to return to baseline
Predisposing factors - AKI
Hypertension
Diabetes
Immunological disease
Hypotensive episode
Exposure to nephrotoxic agents
S/S Prerenal
Volume loss
Hypotension
Oliguria
S/S Renal
Volume overload
Hypertension
Oliguria
S/S Post renal
Infection
Prevention of AKI
Hydration
sepsis / shock
close monitoring
blood products
Pre renal Tx:
fluid replacement
Dopamine
Antidysrhythmic
Renal Tx:
Diuretics
Dopamine
Acetylcysteine
Epoetin Alfa
Na , K, and protein restriction
Diagnostic
X ray - KUB - Cysts
Ultrasound - kidney size
MRI - soft tissue damage
CT - cross sectional
