AKI and HUS Flashcards

1
Q

What is AKI?

A

Abrupt decline in kidney function, resulting in retention of urea and dysregulation of extracellular volume and electrolytes

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2
Q

What are some causes of AKI?

A

Pre-renal= perfusion
Renal= glomerular disease, tubular injury, interstitial nephritis
Post renal= obstruction

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3
Q

What can cause glomerular disease?

A

HUS

Glomerulonephritis

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4
Q

What can cause tubular i jury?

A

Acute tubular necrosis

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5
Q

What can cause interstitial nephritis?

A

NSAIDs

Autoimmune

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6
Q

What are the risk factors for AKI?

A

Nephro-urological, cardiac or liver disease
Malignancy
NEphrotoxic medication
Rely on others for fluid access

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7
Q

What are the features of AKI?

A

Urine output <0.5ml/kg/hr for >8 hours

Plasma creatinine >1.5x age reference range/known baseline

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8
Q

What is the classification of AKI?

A
1= 1.5-2x reference level
2= 2-3x times referene
3= >3x reference
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9
Q

What investigations are done for AKI?

A

FBC, creatinine, U&Es, bone profile
Urinalysis and microscopy
Urinary tract US

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10
Q

What is the management of AKI?

A

Monitor- urine output, weight, BP, PEWS
Maintain circulatory volume
Minimise nephrotoxic drugs

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11
Q

What are some nephrotoxic drugs?

A

NSAIDs
ACEi, ARBs
aminoglycosides
IV contrast

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12
Q

What is HUS?

A

Haemolytic uraemia syndrome

Triad of AKI, microangiopathic haemolytic anaemia, thrombocytopenia

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13
Q

What are the types of HUS?

A

Primary

Secondary= more common

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14
Q

What usually causes HUS?

A

Secondary= infection

  • classically e. coli 0157
  • pneumococcal, HIV
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15
Q

What causes primary HUS?

A

Complement dysregulation

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16
Q

What is the presentation of HUS?

A

Young person
Fever, vomiting, weakness
Bloody diarrhoea
Progresses to AKI after 5-10 days

17
Q

What investigations are done for HUS?

A

FBC, U&Es- anaemia, thrombocytopenia, AKI
Blood film- fragmented
Stool culture

18
Q

What is the management of HUS?

A

Monitor, maintain circulatory volume, minimise nephrotoxic drugs
Dialysis if required

19
Q

What are the complications of HUS?

A

Hypertension
Proteinuria
CKD