AKI/CKD

Question 1

Types of AKI

Answer 1

1. Oliguric
   
   • Acute reduction in urine output to 0.5ml/kg/h
2. Polyuric
   
   • often subacute and clinically inapparent, until fluid intake is reduced and the patient becomes dehydrated due to an inappropriately high urine output.
   • i.e. urine output ≠ GFR

Question 2

Causes of AKI

Answer 2

• Pre-renal:
  
  • vascular insufficiency: dehydration, shock, sepsis, nephrotic syndrome
  • Commonest cause in children
• Renal:
  
  • Crescentic glomerulonephritis: acute post-infections; membranoproliferative; HSP; ANCA-HUS
  • ATN
  • Crush injury (myoglobinuria)
  • UTI with septicaemia
• Post-renal: obstruction

Question 3

Keeping normal kidney functions in mind, what are some clinical features of AKI?

Answer 3

• Water -> oedema
• Na -> HT
• K -> Arrhythmias
• Acid -> Hyperventilation
• Urea -> N, V
• Phosphate -> ↓Ca, tetany, seizures

Question 4

What are the major causes of ESKD in children?

Answer 4

1. GN
2. Hypoplasia/dysplasia
3. Posterior urethral valve