Kidney stuff

Question 1

What are some symptoms of acute kidney injury?

Answer 1

Edema, HTN, decreased urine output

Remember, there are frequently no symptoms of noticeable symptoms

Question 2

Will some one with acute kidney injury have

1. Increased or decreased BUN?
2. Hyper or hypokalemia?
3. Hyper or hyponatremia?

Answer 2

Increased BUN

Hyperkalemia

Hyponatremia

Question 3

What are two ways we can prevent acute kidney injury?

Answer 3

1. Sustain renal perfusion – fluid balance, blood volume, blood pressure maintenance
2. “Don’t clog the pipes” – aggressive IVF in setting of hemolysis or rhabdomyolysis

Question 4

What is the most important step in managing a patient with acute kidney injury?

Answer 4

Searching for and identifying the cause

Question 5

Meticulous management of intake is very important in managing a patient with AKI, what things should we be particularly aware of?

Answer 5

Water (UO + 500mL), meds, proteins, potassium, sodium, and phosphorus

Question 6

What does KDIGO stand for?

Answer 6

Kidney disease improving global outcome

Question 7

What are the two KDIGO guidlines?

Answer 7

Rise in creatinine greater than 0.3 mg/dL from normal

Decrease in urine output to less than 3mL/kg/hr over 6 hours

Question 8

Prerenal azotemia can be due to inadequate perfusion – by what 3 mechanisms?

Answer 8

1. Dehydration (inadequate PO intake, GI losses, diuretics)
2. Cardiac or hepatic failure
3. Prolonged renal ischemia