Clinical - Acute Kidney Injury Flashcards
What are causes of increased serum creatinine levels independant of GFR
Cefoxitin, glucose, ketone bodies, proline, flucytosine
Phabdomyolysis, exercise, meat
What is the first cause of increased serum BUN independent of GFR
Increased SUN (serum urea nitrogen) GI bleeding, tissue trauma, glucocorticoids
What are the three classifications of acute renal failure
Pre-renal
Renal
Post-renal
What is the mechanism of pre-renal failure
Decreased RBF leading to decreased GFR
What are the causes of pre-renal failure
Hypovolemia and decreased cardiac output
Obstruction of renal arteries
Cyclosporin and NSAIDs
Why is a patient taking ACEi or ARB at risk for acute decreases in GFR
Compromised intravascular volumes
CHF
Renal artery stenosis
What are the three most common causes of acute interstitial nephritis
Immunologic
Infectious
Allergic reactions
What are the two etiologic categories of acute tubular necrosis
Kidney ischemia
Nephrotoxic injury
What happens during the inciting phase of acute tubular necrosis
Decrease in urine output and increase is serum creatinine levels
What happens during the maintenance phase of acute tubular necrosis
Oliguric (last 1-3 weeks) usually followed by polyuria
What happens during the recovery phase of acute tubular necrosis
Serum creatinine level and bun decreases and urine output normalizes
What are the two causes of post-renal failure
Urine outflow obstruction Functional obstruction (neurogenic bladder)
What has a fractional excretion of Na less than 1%
Pre-renal
What has a fractional excretion of Na greater than 3%
Intrinsic and post-renal
What four electrolytes must be limited in the diets of acute renal failure patients
K, Na, phosphorus, protein
