[AKI] Flashcards
3
1.5x baseline
or
rise of >26 micromol/L in 48 hours
6 hrs
2-2.9x baseline
12hrs
>3x baseline or >354 micromol/L in 48 hours or RRT
24 hours
or
anuric for 12 hours
Pre-renal
Intrinsic
Post-renal
Pre-renal - 40% - 70%
renal hypoperfusion
Renal artery stenosis
Hypotension
sepsis
cardiac output failure
Tubular
Glomerular
Interstitial
Vascular
acute tubular necrosis
intrinsic
tubular
intrinsic
glomerular
intrinsic interstitial (i.e. infiltration)
Vascular
luminal
mural
extrinsic compression
sloughed papillae
stones
clots
strictures
malignancy
BPH
retroperitoneal fibrosis
post-renal
BPH
USS
distension and dilation of the renal pelvis and calyces
previous high creatinin/low GFR Ix results
Small (<9cm)
Refractory pulmonary oedema persistent hyperkalaemia Severe metabolic acidosis Any uraemic complication Drug overdose
BLAST
Barbituates Lithium Alcohol Salicylates Theophyline
pH <10
Volume status –> euvolaemia
Stop nephrotoxic drugs
nutrition
Raised JVP Raised BP Pulmonary crepitations peripheral oedema Gallop rhythm (cardiac ausculation)
reduced urine output reduced JVP Reduced BP poor tissue turgor Quick pulse
K+ content
catheterise
Uraemic
Pulmonary oedema
Hyperkalaemia
Acidaemia
uraemic encephalitis
uraemic pericarditis
no - just a good marker
reflects a reduction in the excretion of toxins
reduction in GFR
fluid overload
K+ are excreted in the collecting duct
> 5.5 mmol/L
Rhabdomyolysis
Hypoaldosteronism
Tall ‘tented’ T waves
small/absent P wave
Increased PR interval
Widened QRS complex
10mL 10% calcium gluconate (IV) \+ IV insulin \+ IV Glucose
cardioprotective
Insulin stimulates intracellular uptake of K+
So blood glucose is minimally affected by insulin/also facilitates process
salbutamol nebulizer
tachycardia
NaHCO3 50mL/8.4%
Sit up High flow O2 Diamorphine 2.5g IV Cyclizine Furosemide
Venous vasodilator
anti-emitic (SE of diamorphine)
RRT
CTKUB
Haemodialysis
Haemofiltration
wegeners granulomatosis
T