AKI

Question 1

What is AKI?

Answer 1

Acute kidney injury

Question 2

What are symptoms of AKI?

Answer 2

Reduced urine output
N+V
Itching
Hypertension 
Dehydration 
Confusion

Question 3

How is AKI diagnosed?

Answer 3

Creatinine

Urine output

Question 4

What are the AKI stages?

Answer 4

Stage 1

• 50-100% creatinine increase
• 0.5 ml/kg/h for 6 hours

Stage 2

• 100-200% creatinine increase
• 0.5 ml/kg/h for 12 hours

Stage 3

• 200%+ creatinine increase
• 0.3 ml/kg/h for 24 hours

Question 5

How are the causes of AKI classified?

Answer 5

Pre-renal
Renal
Post-renal

Question 6

What are pre-renal causes?

Answer 6

No supply = volume depletion
Slow supply = hypotension
Irregular supply = HF, arrhythmias
Blocked supply = stenosis, cancer

Question 7

What are renal causes?

Answer 7

Glomerular disease

• glomerulonephritis
• haemolytic uraemic syndrome

Tubular disease

• ATN
• drugs

Acute interstitial nephritis

Vasculitis

Eclampsia

Question 8

What are post-renal causes?

Answer 8

Obstruction - stones

Question 9

What bloods would you do for a suspected AKI?

Answer 9

FBC
U+Es
CRP
IgA
Creatinine kinase

Question 10

What investigations would you do for a suspected AKI?

Answer 10

Urine dipstick
USS KUB
CT KUB

Question 11

How do you manage an AKI?

Answer 11

Treat underlying cause
Resus fluids

Dialysis if necessary

Question 12

What are indications for dialysis in AKI?

Answer 12

Refractory hyperkalaemia
Refractory pulmonary oedema
Metabolic acidosis <7.1
Severe uraemia / uraemic complications

Question 13

What are risk factors for developing an AKI?

Answer 13

CKD
HF
DM
Liver disease
>65
Nephrotoxic medications
Contrast use