Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y2 - Urinary > Lecture 11 - Acute Kidney Injury (AKI) > Flashcards

Lecture 11 - Acute Kidney Injury (AKI) Flashcards

1
Q

What is Acute Kidney injury (AKI)?

A

A sudden deterioration of renal function over hours to days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What metabolic products rapidly rise in AKI?

A

Urea
Creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What usually happens to urine output in an AKI?

A

Oliguria
Or
Anuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is oliguria?

A

Reduced urine output
100ml - 400ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Anuria?

A

No urine output or <100ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Uraemia?

A

Clinical symptoms which arise when nitrogenous metabolic waste products accumulate in the blood (urea and creatinine) as a result of decreased filtration of these products by the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the likely cause of patients pathology:

High creatinine
Reduced eGFR
Hypotrophic kidneys

A

Chronic kidney disease

Since the deterioration/reduced function in the kidneys leads to kidney tissue shrinkage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What diuretic is most appropriate in a patient with pulmonary oedema?

What type of diuretic is it?

How does it work?

A

Loop Diuretic

Blocks the NKCC channel in the ascending limb of loop of Henle
Reduces reabsorption of Na+ so more Na+ stays in lumen
This impairs the corticopapillary gradient so less water gets reabsorbed in the CD
More water lost in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the stages of an AKI?

A

1
2
3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What 2 things can be measured to determine stage of an AKI?

A

Serum creatinine

Urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the serum creatinine levels in stage 1 AKI?

What are the urine output levels in a stage 1 AKI?

A

Serum creatinine = 1.5 - 1.9 times baseline

Urine output = <0.5ml/kg/h between hours 6 and 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the serum creatinine levels in stage 2 AKI?

What are the urine output levels in a stage 2 AKI?

A

Serum creatinine = 2 - 2.9 times baseline

Urine output = <0.5ml/kg/h for more than 12hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the serum creatinine levels in stage 3 AKI?

What are the urine output levels in a stage 3 AKI?

A

Serum creatinine = 3 times baseline or serum creatinine > 353.6mmol/L

Urine output = <0.3ml/kg/h for 24hrs or more
Or
Anuria for 12hrs or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stage the AKI on Slide 8

A

70ml urine output
70ml / 6 = 11.67ml/h
11.67 / 69kg = 0.17ml/kg/h

0.17ml/kg/h between 6-12 so STAGE 1 AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 types of cause of AKI?

A

Pre-renal AKIs
Intrinsic renal AKIs
Post renal AKIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some causes of Pre-renal AKIs?

A

Sepsis
Hypovolaemia
Shock
Renal artery stenosis
Congestive Cardiac Failure (CCF)
NSAIDs
ACE inhibitors

Essentially anything that leads to reduced perfusion of kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does Sepsis cause Pre-renal AKIs?

A

Toxins lead to systemic vasodilation

Massive drop in BP

Leads to Renal hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does Hypovoloaemia cause Pre-renal AKIs?

A

Reduced kidney perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does shock cause Pre-renal AKIs?

A

Catastrophic fall in BP
Hypovolaemic
Leads to renal hypoperfusion

20
Q

How does Renal artery stenosis cause Pre-renal AKIs?

A

Occlusion of renal artery
Leads to reduced perfusion of kidney

21
Q

How does Congestive Cardiac Failure cause Pre-renal AKIs?

A

Reduced cardiac output
Less blood to kidneys

22
Q

How do NSAIDs cause Pre-renal AKIs?

A

Blocks prostaglandins so kidneys cant vasodilates afferent arteries or renal artery so reduced blood flow to it

23
Q

How do ACE inhibitors cause Pre-renal AKIs?

A

Can’t restore BP if it drops
RAAS system cant be activated

Leads to renal hypoperfusion

24
Q

What are some intrinsic renal causes of AKI?

A

Acute tubular necrosis
Acute interstitial nephritis
Glomerular disease
Vasculitis

25
How does Acute Tubular necrosis cause Intrinsic-renal AKIs? What can cause Acute Tubular necrosis?
Toxins can cause cell necrosis leading to acute tubular necrosis Rhabdomyolysis - myoglobin is toxin to the kidney
26
What is Acute Interstitial nephritis?
Inflammation in kidney
27
What happens in glomerular disease causing intrinsic Renal AKI?
Where the glomerular capilaries are destroyed
28
What is vasculitis? How can it cause intrinsic renal AKI?
Inflammation of blood vessels in kidney
29
What are the general causes of post-renal AKI?
Anything that blocks the urine output So anything after urine leaves kidney
30
What are some post-renal causes of AKI?
Bilateral calculus Uteric/urethral stricture BPH Tumor Retro-peritoneal fibrosis
31
What is Calculus? Why does the calculus have to be bilateral to cause post renal AKI?
Urinary stones If on one side the other kidney can filter the blood
32
How does a Uteric/urethral stricture cause post-renal AKI?
Blocks urine outflow
33
How does a BPH cause post-renal AKI?
Enlarged prostate squeezes the prostatic urethra
34
How does a retro-peritoneal fibrosis cause post-renal AKI?
Pushes ureters from outside compressing them
35
What are the 4 main complications of AKI?
Metabolic acidosis Hyperkalaemia Uraemia Volume overload
36
How does metabolic acidosis occur with AKI?
Reduced GFR kidney not filtering as much Less able to reabsorb and produce HCO3-
37
How does hyperkalaemia occur with AKI?
Low GFR means less able to remove K+ The hyperkalaemia also contributes to the metabolic acidosis
38
How does volume overload happen with AKI?
Less able to remove water due to reduced GFR
39
What bedside investigations can be done to check for AKI?
Bladder scan Urinalysis, microscopy, culture and specimen ECG (to see any effects of K+)
40
What blood investigations can be done for AKI?
VBG Creatinine kinase (rhabdomyolysis) Immunology screen (vasculitis)
41
What imaging investigations can be done for AKI?
Ultrasound of Kidneys, ureters and Bladder CT scan CXR
42
What is a nephrostomy?
Bag which drains the contents of the kidney
43
What is cytoscopy?
Camera into bladder
44
What are some treatments for a Pre-renal AKI?
Treat underlying cause IV fluids (Hypovolaemia) Stop potentially Nephrogenic medication (NSAIDs ACE inhibitors Diuretics
45
What are some treatments for intrinsic renal AKIs?
Correct electrolytes Renal replacement therapy Call nephrology
46
What are some post-renal treatments of AKI?
Urinary or suprapubic Catheter Ureteric stents Nephrostomy

Y2 - Urinary (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions