L09: Acute Kidney Injury Flashcards
What is acute kidney injury
Short term kidney injury
What do you mean by short term
Hours to days
What do we look at to see stages of acute kidney injury
Creatinine
Or u
Urine output
What happens to creatinine as stages of acute kidney injury increase
Creatinine increase
What happens to urine output as stages of acute kidney injury increase
Decrease
What are the consequences of acute kidney injury
Death
What are the risk factors for patients who are likely to get acute kidney injury
Age Dibaetes mellitus Hypertension Heart disease Liver disease Chronic kidney disease Medications
What are the 3 main categories of causes of acute kindey injury
Pre renal
Renal
Post renal
What is pre renal causes about
Perfusion of the kidney
What is the renal causes about
The kidney itself
What is the post renal causes
Obstruction of the urinary system
In pre renal causes why might people get perfusion failure
Hypotension
Bleed
Heart problems
Drugs that - block renin angiotension
Non steroidal anti inflammatory drugs
Anti hypertensives
Diuretics
What mechanism controls the blood pressure within the arterioles
Autoregulation
What is the blood pressure in perfusion failure
Low
If there is low blood pressure what does this mean in terms of urine output
Urine output is also low
Describe the renin angiotension system when there is low blood pressure
1) low blood pressure is detected by the juxtaglomerular cells
2) this releases renin
3) renin is converted to angiotensin 2
4) adrenal cortex releases aldosterone to the kidney
5) kidney has sodium retention and potassium excretion
6) this increase fluid reabsorption and rises blood volume
7) therefore blood pressure rises
What does NSAIDs cause
Loss of constriction and dilation of arterioles
So low blood flow results in loss of perfusion
What are the treatments for perfusion failure
Fluid replacement to increase blood volume
Blood pressure support
Stop NSAID drugs
Why can obstruction of the urinary system occur in post renal causes
Kidney stones
Benign prostate: squish prostate urethra
Tumours
Fibrosis
What is the treatment of post renal
Remove the obstruction
Remove tumour
Dilation of the strictures in fibrosis
What are the causes that give renal causes
Disease that damage tubules, glomerulus, interstitial space
Systemic disease
Infection
Allergic
Drug toxicity
Glomerulonephritis (inflammation of glomerulus)
What is a systemic vasculitis
ANCA Associated vasculitis
What is systemic vasculitis associated with
Anti neutrophil antibodies
What does antineutrophil antibodies cause
Make neutrophils behave abnormal
Neutrophils stick to endothelium gaps as if there is infection when there isn’t
This causes renal vasculitis
