AKI Flashcards
renal failure
partial or complete impairment of kidney function
-inability to excrete metabolic waste products and water
acute kidney injury
- sudden or rapid reduction in kidney function
- potentially reversible
- mortality rate remains high
causes of acute kidney injury
- prolonged ischemia (hypotension or hypovolemia)
- nephrotoxic agents
azotemia
- accumulation of nitrogenous waste products
- increased BUN/Cr
uremia
- renal function declines to the point that s/s develop in multiple body systems
- UOP
prerenal failure
- caused by external factors
- these factors reduce systemic circulation, leading to decreased renal blood flow
- no actual dmg to the kidneys
intrarenal failure
- conditions that cause direct damage to the renal parenchyma
- these conditions lead to impaired function of the nephron
- d/t prolonged ischemia, nephrotoxins, hemolysis of RBCs, and myoglobin released from necrotic cells
acute tubular necrosis
- most common cause of internal AKI
- constriction, decreased blood flow, decreased GFR, tubular dysfunction, and oliguria
postrenal failure
- mechanical obstruction of the urinary outflow
- urine refluxes into the renal pelvis, impairing function
initiating phase
- causative event
- @ time of insult
- continues until pt has s/s
the faster you go thru the oliguric phase
the faster the prognosis
prerenal oliguria
- SG > 1.025
- low urine Na concentration
- can give fluids to pt
intrarenal oliguria
- normal or fixed SG
- high Na concentration
- RBCs, WBCs in urine
- giving fluids won’t work
diuretic phase
- gradual increase in UOP
- nephrons not fully functional
- kidney has recovered its ability to excrete
- duration: 1-3 weeks
what to monitor in diuretic phase
- large losses of Na, K, dehydration
- acid-base, electrolytes, BUN/Cr begin to normalize
recovery phase
- begins when GFR increases
- BUN/Cr plateau, then drop
- may take up to 12 months to stabilize
outcome of AKI influenced by
- pt’s overall health
- severity of kidney failure
- # and type of complications
primary goal of AK
maintain the body’s normal state as possible while kidneys are repairing themselves
mgmt of AKI
- determine if there is adequate intravascular volume and cardiac output for perfusion
- volume expanders
- lasix
- loop diuretics
- mannitol
- strict I&O
- low protein diet
- Na, K restriction
gerontologic considerations
- functioning nephrons decrease with age
- co-morbidities increase risk of getting AKI
- less likely to recover from AKI
