PHRM 825: AKI and Drug-Induced Nephrotoxicity Flashcards
You lose almost all your kidney function from ___ to ___ SCr.
1-2
Why is CrCl not an accurate measure of kidney function?
- It may be changing rapidly
- Other waste products build up out of proportion due to SCr rise
What can cause community acquired AKI (0.01-0.06%)?
Prerenal azotemia and postrenal obstruction
What can cause hospital acquired AKI (7-18%) or ICU acquired AKI (36-67%)?
- Multiple organ failure (> or = 3 major organs (mortality ~80%)
- Sepsis
- Bleeding
- Volume depletion
- Surgery
What is azotemia?
Elevation in nitrogenous waste products which leas to the clinical syndrome uremia
What is prerenal azotemia?
Hypoperfusion of the kidney (not getting enough blood); can be caused by hemorrhage, dehydration, or HF
What is functional ARF?
A decrease in the glomerular hydrostatic pressure which leads to a decrease in glomerular filtration rate
What medications can cause functional ARF?
NSAIDS and ACE inhibitors
What is Acute renal failure
Damage to the kidney itself
What can cause acute renal failure
Contrast dye, amphoB
What is FEna?
Fractional excretion of sodium
What is FEna used for?
Used to differentiate between prerenal/functional renal failure and intrinsic renal failure
What are some prevention strategies for AKI?
- Use less nephrotoxic agents
- Hydration (increases flushing)
- Sodium loading
What patients are at risk for AKI?
- Older adults
- Patients with abnormal renal function or diabetes
- Volume depleted patients
What are the goals for AKI treatment?
- Remove primary cause
- Limit further nephrotoxin exposure
- Accellerate the recovery
