AKI

Question 1

Define AKI

Answer 1

A syndrome of decreased renal function, measured by serum creatinine or urine output, occurring over days or hours

According to KDIGO, it is either;
Rise in creatinine >26 within 48 hours
Rise in creatinine >1.5x baseline within 7 days
Urine output <0.5 for >6 consecutive hours

Question 2

What are the risk factors for AKI?

Answer 2

Pre existing CKD
Age
Male sex
Malignancy
CVD

Question 3

What are the pre renal causes of AKI?

Answer 3

Haemorrhage, burns, pancreatitis
Cardiogenic shock, MI
Sepsis, drugs

Question 4

What are the intrinsic causes of AKI?

Answer 4

Glomerulonephritis
Drug reaction, infection
Vasculitis

Question 5

What are the post renal causes of AKI?

Answer 5

Stone, renal tract malignancy, stricture, clot

Pelvic malignancy, prostatic hypertrophy

Question 6

What are the commonest causes of AKI?

Answer 6

Sepsis
Major surgery
Cardiogenic shock

Question 7

If a patient is in AKI and is hypovolaemic, what is the management?

Answer 7

Hartmann’s 500ml bolus over 15mins. Reassess after each bolus is given

Question 8

If a patient is in AKI and is hypervolaemic, what is the management?

Answer 8

Fluid restriction
Diuretics
RRT

Question 9

If a patient is in AKI and is hyperkalaemic, what is the management?

Answer 9

First do an ECG
10ml of 10% calcium gluconate or
30ml of 10% calcium gluconate 
Intravenous insulin second line 
RRT if nothing else works