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Renal and Urology > AKI > Flashcards

AKI Flashcards

1
Q

What is AKI?

A

A rapid drop in kidney function diagnosed by measuring serum creatinine

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2
Q

What are the criteria for diagnosis of an AKI?

A

A rise in creatinine of 26 micromol/L or greater within 48 hours
A 50% or greater rise in serum creatinine in 7 days
A fall in urine output to less than 0.5ml/kg/hour for more than 6 hours

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3
Q

What are the risk factors for AKI?

A

Older age
Sepsis
CKD
Heart failure
Diabetes
Liver disease
Cognitive impairment - reduced fluid intake
Medications
Radiocontrast agents

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4
Q

What medications commonly cause AKI?

A

NSAIDs
Gentamicin
Diuretics
ACE inhibitors
ARBs

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5
Q

What are the pre-renal causes of AKI?

A

Dehydration
Shock
- Haemorrhagic shock
- Cardiogenic shock
- Septic shock
- Anaphlactic shock
Heart failure
Drugs

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6
Q

What are the renal causes of AKI?

A

Acute tubular necrosis
Glomerulonephritis
Acute interstitial nephritis
Haemolytic uraemic syndrome
Rhabdomyolysis

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7
Q

What are the post-renal causes of AKI?

A

Kidney stones
Tumours
Ureteral or urethral stricture
BPH
Neurogenic bladder

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8
Q

What is the most common intrinsic cause of AKI?

A

Acute tubular necrosis

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9
Q

What is acute tubular necrosis?

A

The damage and death of epithelial cells of the renal tubules (due to hypoperfusion or nephrotoxins)

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10
Q

What investigations are performed in suspected AKI?

A

Serum creatinine
Urinalysis
Ultrasound of urinary tract (to determine post-renal cause)
ABG
Bloods - FBC, U&E, LFTs, glucose, CK, CRP
ECG - hyperkalaemia
CXR - pulmonary oedema

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11
Q

What is a stage 1 AKI?

A

Rise of >26micromol or more within 48 hours
Rise in creatinine of more than 50% in 7 days
Urine output less than 0.5ml/kg/hour for more than 6 hours

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12
Q

What is a stage 2 AKI?

A

More than 100% rise in creatinine in 7 days
Urine output less than 0.5ml/kg/hour for more than 12 hours

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13
Q

What is a stage 3 AKI?

A

More than 200% rise in creatinine in 7 days
Urine output less than 0.3ml/kg/hour for 24 hours
Anuria for 12 hours

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14
Q

What is the management of AKI?

A

IV fluids
Withhold medications that may worsen the condition
Withhold/adjust medications that may accumulate with reduced renal function
Relieve obstruction in post-renal AKI
Dialysis

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15
Q

What are the complications of AKI?

A

Fluid overload
Heart failure
Pulmonary oedema
Hyperkalaemia
Metabolic acidosis
Uraemia

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16
Q

What are the clinical features of AKI?

A

Reduced urine output
Confusion or drowsiness
Swollen legs
Suprapubic pain
Haematuria
Dry mucous membranes
Reduced BP
Palpable bladder

Renal and Urology (19 decks)

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