ILA AKI

Question 1

what is the normal blood value for sodium?

Answer 1

135-145mmol/L

Question 2

what is the normal blood value for potassium?

Answer 2

3.5-5.4mmol/L

Question 3

what is the normal blood value for urea?

Answer 3

2-7mmol/L

Question 4

what is the normal blood value for creatinine?

Answer 4

55-120umol/L

Question 5

what is the normal GFR?

Answer 5

90-120

Question 6

why are creatinine tests not reliable?

Answer 6

• creatinine - waste product of muscle turnover
  
  • e.g. size of patient must be considered

Question 7

what are the diagnostic criteria for AKI?

Answer 7

one of:
- Rise in Creatinine > 26 micromol/L in 48 hours above baselines
- Rise in Creatinine > 50% (best figure in last 6 months)
- Urine output <0.5ml/kg/hr for > 6 consecutive hours

Question 8

what is pre-renal AKI?

Answer 8

decreased blood flow e.g. due to fluid loss

Question 9

what is renal AKI?

Answer 9

Damage to Tubules, glomeruli, interstitial, vasculature e.g. due to inflammation / trauma

Question 10

what is post renal AKI?

Answer 10

reduced outflow usually due to blockage e.g. due to renal stones or bladder obstruction

Question 11

what happens to BP after IV fluids post dehydration?

Answer 11

BP increases - sympathetic activation constrictions arteries and arterioles which increase vascular resistance and decreases distal blood flow

Question 12

what is the equation for BP?

Answer 12

BP = CO(HR x SV) x SVR

Question 13

what is the MINIMUM and normal healthy urine output?

Answer 13

MINIMUM: 0.5ml/kg/hr
NORMAL: 1-2ml/kg/hr

Question 14

why are NSAIDs nephrotoxic?

Answer 14

inhibit prostaglandins reducing blood flow to kidneys

Question 15

what electrolyte may be raised in AKI and what would the ECG show?

Answer 15

potassium (bad: >7):
- tall T waves
- reduced P wave
- widened QRS

Question 16

how does insulin correct hyperkalaemia?

Answer 16

• Insulin shifts potassium into cells by rapidly stimulating the activity of Na+ - H+ transporter on cell membrane,
• this promotes the entry of sodium into cells, which leads to activation of the Na+ - K+ ATPase, causing an electrogenic influx of potassium.

Question 17

what is given alongside insulin in hyperkalaemia?

Answer 17

50% dextrose to avoid hypoglycaemia