AKI Flashcards
AKI Def
sudden drop in GFR (increase plasma creatinine), decreased urine output
general AKI treatment
address underlying, stop offending, dose for GFR 0, manage electrolytes, diuress
three classifications of AKI
pre renal, intra renal, post relay
pre renal (perfusion) clin
low FeNa, low urine sodium .
pre renal path
decrease PGC: afferent resistance, efferent resistance, drop in systemic PB
intrinsic clin
urine abnormalities (protein, RBC, casts, WBC, sodium
ATN, AIN, RPGN urine
ATN: muddy
AIN: WBC
RPGN: RBC/erythroctes
intrinsic path
tubular interstitial or glomerular. less nephrons/tubular feedback
obstructive path
increase PBS, increase pressure in collecting system… BPH/prostatitis
risk factors for AKi
CID, advanced age, DM, underlying heart or liver disease (decreased perfusion)
AKI basic clinical
impaired clearance, fluid overload, hyperkalemia, metabolic acidosis
intrinsic physical exam
look for perfusion issues plus fever/rash (AIN)
obstructive physical exam
suprapubic fullness, CVA tenderness
crystals in urine sed is suggestive of what
obstructive (may also have RBC)
which AKI have minimal protinuria
perffusion and obstructive
which has moderate proteinuria
acute GN
what is typically seen in urine with RBC casts
proteinuria
when would you see WBC casts
AIN, pyelonephritis (with bacteria)
waxy casts are seen with
advanced CKD
fatty casts are seen with
nephrotic syndrome
worst case AKI
UREMIA and AEIOU
what are the muddy brown casts
dead/shed tubular epithelium
what nerve is at risk to cut in C section
iliohypogastric
