ARF/CKD Flashcards
acute renal failure is the same thing as acute kindney injury. the rapid reduction of kidney function occurs over what time frame?
hours to days
Ability to regain kidney function is directly related to duration of ? and ?
oliguria and anuria
fancy name for build of nitrogenous waste =
azotemia
give me some examples of causes of pre-renal AKI
Reduced perfusion = PRERENAL
* Shock
* Hypotension
* Anything that blocks blood flow to kidneys (Atherosclerosis)
give me some examples of causes of intra-renal AKI
Kidney Damage = INTRARENAL
* Glomerulonephritis
* Lupus
* Drugs that damage to the kidney- drugs, aminoglycosides, IV contrast
* Toxins
* Ischemia
give me some examples of post-renal AKI
Obstruction = POSTRENAL
* Bladder Cancer
* Kidney Stones
* Prostate cancer or BPH
most patients in the hospital are at risk of develping what thing with their kidneys?
AKI (30% ICU, 10% general admission)
Pre and Post renal AKI compensate in what same 3 ways
- Activating R-A-A system
–> Increase the BP to increase chanse of perfusion - Constricting Kidney Blood Vessels
–>To raise the pressure and increase chance of perfusion - Releasing ADH
—> Hold onto salt and fluid to increase chance of perfusion
the result of pre and post renal compensation is….
- oliguria/anuria
- holding onto fluid + nitrogenous waste
- increasing blood volume and kidney perfusion
oliguria is < ____ ml day
400
assessment findings for AKI
oliguria
fluid overload/increase BP
N/V (azotemia)
Confusion (azotemia, poor brain perfusion)
AKI labs: elevated or low?
creatinine
BUN
K
all elevated!
3 early signs of AKI =
- low UOP
- edema
- increase creatinine
for AKI maintain a map > ____
65
interventions for AKI (4)
- central venous pressure monitoring thru superior vena cava
- CCB
- Nutrition/fluid
- dialysis (maybe- not everyone needs it)
how much protein should someone with AKI have?
40 g/ day (more if on dialysis )
how do we calculate fluid restrictions for AKI?
24 hour UOP + 500 ml
AKI need a diet low in which 2 elements?
phosphorous and potassium
–> remember these are high b/c their kidneys can’t filter it out
AKI need a diet low in which 2 elements?
phosphorous and potassium
–> remember these are high b/c their kidneys can’t filter it out
Your patient has a history of hypertension and is admitted for hypertensive crisis. He is on a nicardipine drip with parameters to keep the blood pressure below 180/100. Currently, your patient’s blood pressure is 96/58 and the drip is running at 25mg/hr. You notice that your patient’s urinary output is 80 mL over the last four hours. After reducing the rate of the nicardipine drip, what is your next priority action?
A) Check the patency of the foley catheter
B) Call rapid response
C) Call the provider
D) Give the patient a bolus of NS
A.) Check the patency of the foley catheter
High BP = interrenal
Bottom out BP –>prolly not enough BP to perfuse kidneys now b/c they live at a high BP, not prerenal
2 distinct factors that sepereate AKI from CKD
CKD is progressive and irreversible
CKD leads to what kind of kidney disease?
end stage kidney disease
How do we stage CKD?
based on GFR
This stage has a normal GFR/ Increased risk for kidney damage – with diagnosis like diabetes, lupus, HTN
Stage 1 CKD
