AKI - investigations

Question 1

what are the functions of the kidney?

Answer 1

REGULATION OF BLOOD VOLUME & BP
regulate pH, electrolytes & osmolarity
excrete waste products
metabolism of drugs

Question 2

what are the endocrine functions of the kidneys?

Answer 2

1-alpha calcidol (vit D metabolism, bone disease)
renin
erythropoeitin (anaemia)

Question 3

which serum biochemistry do you look for in ALL AKI?

Answer 3

increase in urea & creatinine

Question 4

what may or may not be present in the serum biochemistry of AKI?

Answer 4

hyperkalaemia
hyponatraemia
hypocalcaemia & hyperphosphataemia (increase phosphate, decrease calcium)

Question 5

why may AKI cause hyperkalaemia?

Answer 5

less H+ ion in, so less K+ out (via NHE), less renal excretion

Question 6

what are signs of hyperkalaemia in ECG?

Answer 6

tall, tented T waves
absent P wave
increase P-R interval
wide QRS
sine-wave
asystole

Question 7

what do you treat hyperkalaemia with in AKI?

Answer 7

IV calcium gluconate

Question 8

what might AKI cause hyponatraemia?

Answer 8

decrease reabsorption of Na+

Question 9

why might AKI cause hypocalcaemia & hyperphosphataemia?

Answer 9

low GFR, not secreting phosphate (phosphate remains in serum & bind to calcium, decrease serum Ca - increase risk of Calcium phosphate stone formation)