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Renal Final > Approach to Diagnosis of Acute Kidney Disease > Flashcards

Approach to Diagnosis of Acute Kidney Disease Flashcards

1
Q

definition of kidney disease

A
  • alteration in kidney structure or function

- GFR < 60

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2
Q

if kidney disease has been going on for more than 3 months it is considered

A
  • chronic kidneys disease
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3
Q

if kidney disease has been going on for less than 3 months it is considered

A
  • acute kidney disease
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4
Q

if the kidney disease has been going on for hours to days (2-7 days), it is considered

A
  • acute kidney injury
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5
Q

AKI and AKD can occur in

A
  • CKD
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6
Q

AKI and AKD can lead to

A
  • CKD
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7
Q

decreased urine output is a sign of

A
  • AKD/AKI
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8
Q

small, echogenic kidneys on ultrasound is a sign of

A
  • CKD
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9
Q

causes of AKD can be classified into

A
  • pre-renal
  • intra-renal
  • post-renal
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10
Q

cause of pre-renal kidney disease

A
  • reduced renal perfusion
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11
Q

cause of intra-renal kidney disease

A
  • vascular
  • glomerular
  • tubular
  • interstitial injury
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12
Q

cause of post-renal kidney disease

A
  • obstructed kidney

- interference with normal urine flow

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13
Q

causes of decreased renal perfusion

A
  • low ECF volume

- altered renal blood flow or hemodynamics

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14
Q

causes of low ECF volume

A
  • GI losses
  • hemorrhage
  • diuretics
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15
Q

causes of altered renal blood flow or hemodynamics

A
  • sepsis
  • heart failure
  • cirrhosis/hepatorenal syndrome
  • hypercalcemia
  • medications
  • vascular disease
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16
Q

causes of intra-renal kidney disease

A
  • glomerular disorders
  • acute interstitial nephritis
  • tubular obstruction
  • acute tubular necrosis
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17
Q

causes of acute interstitial nephritis

A
  • medication induced
  • autoimmune
  • infection related
18
Q

causes of tubular obstruction

A
  • crystals
  • tumor lysis
  • myeloma casts
19
Q

causes of acute tubular necrosis

A
  • ischemic

- nephrotoxic

20
Q

ischemic causes of acute tubular necrosis

A
  • decreased effective renal perfusion

- prolonged renal state

21
Q

nephrotoxic causes of acute tubular necrosis

A
  • nephrotoxic medications
  • heme pigments
  • iodinated radiocontrast
22
Q

initiating phase of acute tubular necrosis lasts how long

A
  • hours to days
23
Q

definition of initiating phase of acute tubular necrosis

A
  • time from onset of precipitating event until tubular injury occurs
24
Q

maintenance phase of acute tubular necrosis lasts how long

25
maintenance phase of acute tubular necrosis characterized by
- marked decrease in GFR | - risk of electrolyte abnormalities
26
recovery phase of acute tubular necrosis is the period during which what takes place?
- repair of renal tissue
27
abnormal urine with RBCs, RBC casts, and proteinuria will lead us to what condition
PRE-RENAL - glomerulonephritis - vasculitis - thrombotic microangiopathy - Atheroemboli
28
abnormal urine with WBCs, WBC casts, and eosinophils will lead us to what condition
- pyelonephritis - interstitial nephritis - atheroemboli - glomerulonephritis
29
abnormal urine with RTE cells and pigmented cells will lead us to which conditions
- tubular injury (acute tubular necrosis)
30
acute tubular necrosis will have what in the urine
- granular "muddy brown" casts
31
if fractional excretion of Na is <1% the condition is mostly due to exceptions
- pre-renal - glomerulonephritis/vasculitis - radiocontast and heme pigement ATN - ATN + chronic pre-renal condition - nonoliguric ATN
32
if fractional excretion of Na is > 1% the condition is mostly due to exceptions
- acute tubular necrosis - chronic kidney disease - diuretic use in past 24-48 hours
33
how to calculate fractional excretion
Urine_x * serum creatinine -------------------------------------------- Urine_Cr * BUN
34
fractional excretion of urea < 35% suggests what cause
- pre-renal
35
fractional excretion > 50% suggests what cause
- acute tubular necrosis
36
urine hyaline casts suggest what causes
- pre-renal
37
urine granular casts suggest what causes
- acute tubular necrosis
38
how do kidneys try to compensate for diminished perfusion how do NSAIDs stop this
- increasing afferent arteriolar dilation | - block intra-renal prostaglandins and block afferent dilation causing reduction in GFR
39
definition of renal papillary necrosis
- necrosis and sloughing of the papillae from impairment of blood flow
40
renal papillary necrosis associated with
- NSAIDS - Diabetes Mellitus - Sickle Cell Disease/Trait
41
treatment of renal papillary necrosis
- supportive

Renal Final (13 decks)

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