AKI Flashcards
What are the causes of transient non-visible haematuria?
UTI
Menstruation
Vigorous exercise
Sexual intercourse
Causes of persistent non-visible haematuria?
Cancer (bladder renal prostate) Stones BPH Prostatitis Urethritis Renal causes- IgA Neph,
Criteria for urgent 2 week cancer referral for haematuria?
> 45 with unexplained visible haematuria w/o UTI. Or visible haematuria that persists after successful Rx of UTI.
> 60 with unexplained non-visible haematuria and either dysuria or a raised WCC on blood test
Main causes of pre renal AKIs?
Dehydration/ haemorrhage/
Distributive shock
Congestive heart failure
Renal artery stenosis/ embolism
Describe the process of AKI due to a pre-renal cause
Decreased blood flow to the kidney
Lowers the GFR
Less urea and creatinine are removed from the blood
Less urine production – oliguria
RAAS stimulated – reabsorption of Na (and water.. and urea) into the blood!
BUN:creatinine raised >20:1 (normal 5-20:1)
What are the main causes of intrarenal AKI?
Acute tubular necrosis (ischemia - including prerenal causes) nephrotoxins including drugs And uric acid (complication of cancer treatment - Tumour lysis syndrome.)
Glomerulonephritis - damage causing leaking of proteins and blood into urine. Oedema and HTN
Acute interstitial nephritis - often caused by meds
Leads to renal papillary necrosis
Describe the AKI mechanism in intrarenal ATN?
The tubules get plugged with debris, creating a high pressure in the tubules leading to low GFR, oligouria and less filtration of urea and creatinine. Also dead cells unable to reabsorb or secrete molecules including k+ and h+.
Brown grannular casts also produced.
Definition of AKI
Acute significant decline in renal function
Raised urea and creatinine
Causes of pre renal AKI
Shock Renovascular disease (RAS, drugs, thromobosis, hepatorenal syndrome)
What do the bloods show in rhabdomyolysis?
High CK
High K
High PO4
High urate
