L09: Acute Kidney Injury

Question 1

What is acute kidney injury

Answer 1

Short term kidney injury

Question 2

What do you mean by short term

Answer 2

Hours to days

Question 3

What do we look at to see stages of acute kidney injury

Answer 3

Creatinine
Or u
Urine output

Question 4

What happens to creatinine as stages of acute kidney injury increase

Answer 4

Creatinine increase

Question 5

What happens to urine output as stages of acute kidney injury increase

Answer 5

Decrease

Question 6

What are the consequences of acute kidney injury

Answer 6

Death

Question 7

What are the risk factors for patients who are likely to get acute kidney injury

Answer 7

Age 
Dibaetes mellitus 
Hypertension 
Heart disease
Liver disease
Chronic kidney disease 
Medications

Question 8

What are the 3 main categories of causes of acute kindey injury

Answer 8

Pre renal
Renal
Post renal

Question 9

What is pre renal causes about

Answer 9

Perfusion of the kidney

Question 10

What is the renal causes about

Answer 10

The kidney itself

Question 11

What is the post renal causes

Answer 11

Obstruction of the urinary system

Question 12

In pre renal causes why might people get perfusion failure

Answer 12

Hypotension
Bleed
Heart problems

Drugs that - block renin angiotension
Non steroidal anti inflammatory drugs
Anti hypertensives
Diuretics

Question 13

What mechanism controls the blood pressure within the arterioles

Answer 13

Autoregulation

Question 14

What is the blood pressure in perfusion failure

Answer 14

Low

Question 15

If there is low blood pressure what does this mean in terms of urine output

Answer 15

Urine output is also low

Question 16

Describe the renin angiotension system when there is low blood pressure

Answer 16

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

Question 17

What does NSAIDs cause

Answer 17

Loss of constriction and dilation of arterioles

So low blood flow results in loss of perfusion

Question 18

What are the treatments for perfusion failure

Answer 18

Fluid replacement to increase blood volume
Blood pressure support
Stop NSAID drugs

Question 19

Why can obstruction of the urinary system occur in post renal causes

Answer 19

Kidney stones
Benign prostate: squish prostate urethra
Tumours
Fibrosis

Question 20

What is the treatment of post renal

Answer 20

Remove the obstruction
Remove tumour
Dilation of the strictures in fibrosis

Question 21

What are the causes that give renal causes

Answer 21

Disease that damage tubules, glomerulus, interstitial space
Systemic disease
Infection
Allergic
Drug toxicity
Glomerulonephritis (inflammation of glomerulus)

Question 22

What is a systemic vasculitis

Answer 22

ANCA Associated vasculitis

Question 23

What is systemic vasculitis associated with

Answer 23

Anti neutrophil antibodies

Question 24

What does antineutrophil antibodies cause

Answer 24

Make neutrophils behave abnormal
Neutrophils stick to endothelium gaps as if there is infection when there isn’t
This causes renal vasculitis

Question 25

What is the treatment for renal vasculitis

Answer 25

Steroid to treat inflammation
Cyclophosamide
Plasma exchange
Azathiprine

Question 26

What is the role of cyclophosphamide

Answer 26

Suppers the immune system

Question 27

What is the role of plasma exchange

Answer 27

Get rid of all antibodies

Question 28

What are the most common causes of death in patients with acute kidney injury

Answer 28

Overwhelming infection

CVS disease