AKI Flashcards

1
Q

What is the definition of AKI?

A

Failure of renal excretory function due to reduction of the GFR
Abrupt sustained rise (for 1-7 days being longer than 24 hours) in serum urea and creatinine
Creatinine from >1.5 times from baseline
Urine output from <0.5mL/kg/h >6h

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2
Q

How common is AKI?

A

15% of adults admitted to hospital develop AKI

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3
Q

What is the pathophysioloyg of AKI’s?

A
  • GFR is controlled by prostaglandins and angiotensin II
  • Leads to failure of:
  • Erythropoietin production
  • Vitamin D hydroxylation
  • Regulation of acid base balance
  • Regulation of salt and water balance
  • Blood pressure control
  • Classified as prerenal, renal or postrenal
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4
Q

What are the risk factors/aetiology of AKI?

A
  • Post surgery
  • Pre-renal failure:
  • Fluid depletion
  • Hypotension
  • Impaired cardiac pump efficiency
  • Vascular disease limiting renal flow
  • NSAIDs
  • ACE inhibitors
  • Renal:
  • Systemic infection
  • Nephrotoxic drugs
  • Renal parenchymal disease
  • Post renal:
  • Enlarged palpable kidney/bladder
  • Large prostate
  • Pelvic masses
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5
Q

What are the sign/symptoms of AKI?

A
↓ in excretion of nitrogenous waste – normally urea is measured 
•	Weakness
•	Fatigue
•	Anorexia
•	Pruritis
•	Bruising
•	Nausea/vomiting
•	Breathlessness – due to anaemia and pulmonary oedema 
•	Metal confusion
•	Seizures
•	Coma
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6
Q

What investigations are conducted for suspected AKI?

A
  • FBC
  • ↓ RBC
  • ↑ ERS
  • U&E’s
  • ↑ Urea
  • ↑ Creatinine
  • ↑ potassium
  • ↑ HCO3 = metabolic acidosis
  • ↓ Ca
  • ↑ phosphate
  • eGFR
  • Urine dipstick
  • ↑ specific gravity in pre renal
  • ↓ Na in intrinsic
  • US
  • Renal biopsy – for unexplained AKI
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7
Q

What are the surgical treatments for AKI?

A
  • Catheter

* Dialysis/haemofiltration

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8
Q

What are the pharmacological treatments for AKI?

A
  • Fluids

* Blood transfusion

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9
Q

What are the non pharmacological treatments for AKI?

A
  • Enteral nutrition
  • Restrict Na and K
  • Avoid nephrotoxic drugs
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