AKI

Question 1

AKI def

Answer 1

decrease in GFR
Inc creatinine
Inc urea
Dec urine output

Question 2

Pre-renal AKI

Answer 2

Decreased perfusion to kidney

Question 3

Causes of pre-renal AKI

Answer 3

• Hypovolaemia - haemorrhage, vomiting, and diarrhoea
• Low effective arterial blood volume (EABV) - HF, cirrhosis, sepsis
• Anatomical - renal artery stenosis
• Drug-induced - NSAIDs, ACEi, diuretics

Question 4

Intra-renal AKI

Answer 4

Structural/functional change of the nephron

Question 5

Causes of intra-renal AKI

Answer 5

• Acute tubular necrosis - ischaemic/toxic injury to PCT
• Acute interstitial nephritis - drug induced, infection induced, immune mediated
• Glomerular disease - nephritic/nephrotic syndrome.
• Intra-tubular obstruction pigment (e.g. rhabdomyolysis)

Question 6

Post-renal AKI

Answer 6

Obstruction

Question 7

Causes of post-renal AKI

Answer 7

Ureters
Bladder
Prostate
Urethra

Question 8

Nephrotoxic drugs

Answer 8

ACEi
NSAIDs
Aminoglycosides

Question 9

AKI Ix

Answer 9

U & Es
FBC
LFTs
VBG

Question 10

AKI Mgx

Answer 10

• stop nephrotoxic meds
• Fluids (in hypovolaemia/hypotension)

Question 11

Stage 1 AKI Creatinine & urine

Answer 11

> 1.5 - 1.9 X (7days)

<0.5ml/kg/hr (6hrs)

Question 12

Stage 2 AKI Creatinine & urine

Answer 12

> 2 - 2.9 X (7 days)

<0.6ml/kg/hr (>12hrs)

Question 13

Stages 3 AKI Creatinine & urine

Answer 13

> 3 X

<0.3ml/kg/hr (>24hrs)