Haemolytic Uraemic Syndrome (+ AKI) Flashcards
What is an acute kidney injury?
an abrupt loss of kidney function resulting in:
- retention of urea and other waste products
- dysregulation of extracellular volume and electrolytes
what happens to the blood levels in AKI?
Low calcium
High phosphate
Metabolic acidosis
Rapid rise in plasma creatinine
What are other signs of AKI?
Hypertension (Due to fluid overload)
How is anuria/oliguria defined?
<0.5mls/kg/hr.
How is AKI defined using creatinine?
Serum creatinine has to be >1.5x the upper limit of normal for that child.
What are the stages of AKI using creatinine?
AKI 1: >1.5-2x the upper limit of normal
AKI 2: 2-3x the upper limit of normal
AKI 3: >3x the upper limit of normal.
What are the stages of AKI using creatinine?
AKI 1: >1.5-2x the upper limit of normal
AKI 2: 2-3x the upper limit of normal
AKI 3: >3x the upper limit of normal.
How are ALL AKIs managed (regardless of their cause)?
Monitor: Urine output, PEWS (response rate, sats, HR, BP, Temp), weight
Maintain: Good hydration, electrolytes, acid base
Minimise drugs: No antibiotics
what are the pre renal causes of AKI?
Pre renal (perfusion problems): Acute haemorrhage Gastroenteritis Liver disease Nephrotic syndrome Anything that reduces perfusion to the kidney Drugs Renal artery stenosis Volume depletion
What are the intrinsic causes of AKI?
Haemolytic uraemia syndrome
Glomerulonephritis (FGSG, MCD, IgA, post strep)
Acute tubular necrosis
Nephritis (NSAIDs, autoimmune, antibiotics, lupus)
What are the post renal causes of AKI?
Obstructive uropathies.
What is haemolytic uraemic syndrome?
usually occurs when theres thrombosis in the small blood vessels throughout the body.
What triggers HUS?
The shiga toxin - produced by Shigella and E.Coli 0157.
These pathogens cause gastroenteritis.
Antibiotic and loperamide use makes this worse.
What is the triad seen in haemolytic uraemia syndrome?
Haemolytic anaemia (breakdown of RBCs)
AKI
Thrombocytopenia (low platelet count).
How does HUS usually present?
Bloody diarrhoea 5 days later - start to show symptoms of HUS: reduced urine output lethargy hypertension confusion haematuria bruising
