AKI (Selby)

Question 1

AKI stage 1

Answer 1

1.5-1.9 times baseline or >0.3 mg/dL increase of serum creatinine

or

<0.5mL/kg for 6-12 hours

Question 2

AKI stage 2

Answer 2

2.0-2.9 times baseline creatinine

or

<0.5 mL/kg for >12 hours

Question 3

AKI stage 3

Answer 3

3 times baseline or >4.0mg/dl increase of serum creatinine

or

<0.3 mL/kg for >24 hours or anuria for >12 hours

Question 4

prerenal AKI cause

Answer 4

hypotension
hypovolemia
reduced CO
systemic vasodilation

Question 5

postrenal AKI

Answer 5

bladder outlet obstruction (BPH/cancer/blood clot)

ureteral obstruction

renal pelvis (papillary necrosis or stones)

Question 6

intrinsic AKI

Answer 6

tubular necrosis (85%)
interstitial nephritis (10%)
glomerulonephritis (5%)

Question 7

tubular necrosis

Answer 7

ischemia (50% of intrinsic cases)

toxins (35% of intrinsic cases)

Question 8

clinical presentation of AKI

Answer 8

edema
HTN
oliguria
foamy urine
hematuria
SoB (if pulmonary edema)
uremia (nausea/vomiting)
pericardial friction rub
asterixis
uremic frost

Question 9

labs to obtain for AKI

Answer 9

urinalysis with urine microscopy

urine albumin/creatinine ration or urine protein/creatinine ratio

Question 10

renal US in AKI

Answer 10

rule out hydronephrosis
evaluate size
cortical thickness

if doppler can assess renal vein thrombosis or renal artery stenosis

Question 11

BUN:creatinine in AKI

Answer 11

> 20:1 suggestive of prerenal azotemia

Question 12

FeNa <1%

Answer 12

prerenal azotemia

Question 13

FeNa>2%

Answer 13

ATN

Question 14

FeUrea <35%

Answer 14

prerenal azotemia

Question 15

FeUrea >50%

Answer 15

ATN

Question 16

renal biopsy in AKI

Answer 16

reserved for sever AKI with unclear etiology

Question 17

urine eosinophils good for

Answer 17

AKI

Question 18

complications of AKI

Answer 18

hypovolemia
electrolyte abnormalities
hyperuricemia
uremia
pericarditis
metabolic acidosis
bleeding
need for dialysis

Question 19

electrolyte abnormalities in AKI

Answer 19

hyperkalemia
hyperphosphatemia
hypermagnesemia

hypocalcemia

Question 20

bleeding in AKI

Answer 20

platelet dysfunction occurs with BUN > 100

Question 21

treatment for AKI is mostly

Answer 21

supportive

also correct underlying condition

Question 22

prerenal AKI need

Answer 22

fluids

Question 23

ATN need

Answer 23

supportive care

Question 24

glomerulonephritis AKI need

Answer 24

probably immunosuppression or plasmapheresis

Question 25

drug induced ATN need

Answer 25

to discontinue the agent