AKI (Part II)

Question 1

Diagnostic criteria for AKI according to KDIGO?

Answer 1

• Increase in serum creatinine by ≥0.3 mg/dl (≥26.5 μmol/l) within 48 hours; or
• Increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or
• Urine volume <0.5 ml/kg/h for 6 hours.

Question 2

Non-modifiable risk factors for developing AKI in ICU ?

Answer 2

• Older than 65yo
• Male gender
• Black people
• HTN, DM, CKD, CCF, PVD, COPD, Obesity, Ca

Question 3

Influence of Leptin on AKI ?

Answer 3

There is increased production of Leptin in adipose tissue which contributes to increased tubular proliferation and fibrosis

Question 4

What are the disease related modifiable risk factors for developing AKI ?

Answer 4

• Sepsis
• Hypovolaemia ( Direct or redistributive)
• Hypervolaemia
• Nephrotoxins
• Major surgery
• Trauma / Burns
• Critical illness
• Anaemia
• Covid-19

Question 5

Give examples of nephrotoxic drugs ?

Answer 5

• Aminoglycosides
• Penicillin
• Glycopeptides
• Antifungals
• Antivirals
• PPI
• NSAIDs
• Immunosuppressants

Question 6

What are the short-term effects of AKI ?

Answer 6

See attached image

Question 7

What are the risk factors for non-recovery of renal function?

Answer 7

• CKD
• Advanced age
• Comorbidities
• Critical illness
• Duration and severity of AKI

Question 8

What are the measures to promote renal recovery?

Answer 8

• Prevention of hyperglycaemia
• Avoiding nephrotoxic drugs
• Avoidance of renal hypoperfusion
• Use of RRT / Avoiding fluid overload