AKI and HUS Flashcards
What is AKI?
Abrupt decline in kidney function, resulting in retention of urea and dysregulation of extracellular volume and electrolytes
What are some causes of AKI?
Pre-renal= perfusion
Renal= glomerular disease, tubular injury, interstitial nephritis
Post renal= obstruction
What can cause glomerular disease?
HUS
Glomerulonephritis
What can cause tubular i jury?
Acute tubular necrosis
What can cause interstitial nephritis?
NSAIDs
Autoimmune
What are the risk factors for AKI?
Nephro-urological, cardiac or liver disease
Malignancy
NEphrotoxic medication
Rely on others for fluid access
What are the features of AKI?
Urine output <0.5ml/kg/hr for >8 hours
Plasma creatinine >1.5x age reference range/known baseline
What is the classification of AKI?
1= 1.5-2x reference level 2= 2-3x times referene 3= >3x reference
What investigations are done for AKI?
FBC, creatinine, U&Es, bone profile
Urinalysis and microscopy
Urinary tract US
What is the management of AKI?
Monitor- urine output, weight, BP, PEWS
Maintain circulatory volume
Minimise nephrotoxic drugs
What are some nephrotoxic drugs?
NSAIDs
ACEi, ARBs
aminoglycosides
IV contrast
What is HUS?
Haemolytic uraemia syndrome
Triad of AKI, microangiopathic haemolytic anaemia, thrombocytopenia
What are the types of HUS?
Primary
Secondary= more common
What usually causes HUS?
Secondary= infection
- classically e. coli 0157
- pneumococcal, HIV
What causes primary HUS?
Complement dysregulation
What is the presentation of HUS?
Young person
Fever, vomiting, weakness
Bloody diarrhoea
Progresses to AKI after 5-10 days
What investigations are done for HUS?
FBC, U&Es- anaemia, thrombocytopenia, AKI
Blood film- fragmented
Stool culture
What is the management of HUS?
Monitor, maintain circulatory volume, minimise nephrotoxic drugs
Dialysis if required
What are the complications of HUS?
Hypertension
Proteinuria
CKD
