Module 10: AKI

Question 1

Pre-renal d/t

FeNa___

Answer 1

vRenal blood flow (vGFR)
d/t NSAIDS, HF, vasoconstriction of renal arteries from meds/shock states
FeNa<1%, Cr ratio >20

Question 2

what is used to differentiate between pre-renal aki and acute tubular necrosis?

Answer 2

FeNa (fractional excretion of sodium)

measures urine and serum sodium and creatinine

Question 3

FeNa>2% indicates what

Answer 3

kidneys are wasting sodium/acute tubular necrosis

Question 4

BUN/Cr ratio differentiates between pre or intra-renal aki

>___= pre-renal

Answer 4

> 20=pre-renal

Question 5

two main causes of intrarenal aki

Answer 5

inflammatory conditions

acute tubular necrosis

Question 6

acute tubular necrosis

Answer 6

^tubular pressure d/t obstruction=
vGFR=Afferent arteriole vasoconstricts =vvvGFR
=backflow of fluid into the renal interstitial tissue

Question 7

Acute tubular necrosis, Cr will rise until it peaks,
While Cr rises, pt at risk for electrolyte imbalances (3)
When Cr falls=____, before this at risk for ___

Answer 7

^K, ^phos, vCa
diuresis, can get dehydrated
volume overload

Question 8

Causes of ATN (4)

Answer 8

sepsis, post-surgical/obstetric complications, medication (aminoglycosides)

Question 9

Most common cause of intrarenal injury

Answer 9

ATN d/t ischemia

Question 10

Post renal AKI caused by

leads to ATN d/t

Answer 10

urinary tract/bladder outlet obstruction
ie BPH/stone
^retrograde pressure

Question 11

AKI s/s

Answer 11

oliguria/anuria
fatigue, dyspnea, edema
uremia=mental status change
electrolyte imbalance (^K,vNa)
metabolic acidosis 
muddy brown cast cells seen in UA w/ ATN