classification and causes of AKI Flashcards
what is the definition of prerenal failure
Azotemia caused by hypoperfusion of the kidneys
what is intrarenal failure
Intrinsic causes, paranchyma or nephron is damaged
What is postrenal failure
Outflow of urine is obstructed
Most common causes of prerenal failure
- volume depletion
- Impaired cardiac efficiency
- Vasodilation
what are the causes of volume depletion in prerenal failure?
- Hemorrhage
- Renal losses (diuretics, osmotic diuresis)
- GI losses (vomiting, diarrhea, nasogastric suction)
what are the causes of Impaired cardiac efficiency in prerenal failure
- Myocardial infarction
- Heart failure
- Dysrhythmias
- Cardiogenic shock
what are the causes of vasodilation in prerenal failure
- Sepsis
- Anaphylaxis
- Antihypertensive medications or other medications that cause vasodilation
What are the causes of renal ischemia in intrarenal failure?
- Pigment nephropathy (associated with the breakdown of blood cells containing pigments that occlude kidney structures)
- Myoglobinuria (trauma, crush injuries, burns)
- Hemoglobinuria (transfusion reaction, hemolytic anemia)
- Rhabdomyolysis
What are the infectious processes that cause intrarenal failure
Acute pyelonephritis
Acute glomerulonephritis
What are the nephrotoxic agents that cause intrarenal failure
- Aminoglycoside antibiotics (gentamicin, tobramycin)
- Antirejection medications (cyclosporine, tacrolimus)
- Radiopaque contrast agents
- Heavy metals (lead, mercury)
- Solvents and chemicals (ethylene glycol, carbon tetrachloride, arsenic)
- NSAIDs
- ACE inhibitors
What are the causes of renal obstruction in posrenal failure?
- Calculi (stones)
- Tumors
- Benign prostatic hyperplasia (BPH)
- Strictures
- Blood clots
How can we prevent pre-renal failure?
Prevent and treat hypotension
Monitor I&O carefully
Monitor Lab work
Provide adequate hydration to patients
Monitor for signs of dehydration
How can we prevent Intra-renal failure?
Monitor changes in renal function
Check BUN and Creatinine before during and after treatment with nephro toxic medication
discontinue use of metfromin before use of CT Dye
How can we prevent Post- Renal Failure
Educate patient on when to contact provider for sudden decrease in urine output
prevent and treat infection promptly to avoid sepsis
intervene promptly with wounds and burns to prevent sepsis
meticulous care of patients with catheters, and remove them as quickly as possible
Monitor I & O closely
Assess Lab values regularly
