Renal

Question 1

What are the NICE criteria for AKI?

Answer 1

1. Creatinine rise >25umol/L in 48h
2. Creatinine rise >50% in 7 days
3. Urine output <0.5ml/kg/hr for >6h

Question 2

Give 3 common causes of pre-renal AKI

Answer 2

Dehydration |
Hypotension |
Heart failure |

Question 3

Give 3 causes of intrinsic renal AKI

Answer 3

Glomerulonephritis |
Interstitial nephritis |
Acute tubular necrosis

Question 4

Give 3 causes of post-renal AKI

Answer 4

Kidney stones |
Masses, eg. Cancer in abdo/prostate |
Ureter/urethral strictures |
BPH

Question 5

What Ix would you do in AKI?

Answer 5

Urinalysis |
US KUB (can be useful to look for obstruction) |
Bloods (U+Es)

Question 6

Management of AKI?

Answer 6

Correct underlying cause |
Stop nephrotoxics (eg NSAIDs) |
Stop antihypertensives |
Relieve obstruction if post-renal |
Fluids

Question 7

Give 4 complications of AKI

Answer 7

Hyperkalaemia |
Fluid overload, eg pulmonary oedema |
Metabolic acidosis |
Uraemia - can lead to encephalopathy and pericarditis

Question 8

What are the key causes of CKD?

Answer 8

Diabetes |
Hypertension |
Age-related decline |
Glomerulonephritis |
Polycystic kidney disease |
Drugs, eg NSAIDs / PPI / lithium

Question 9

What are the RFs for CKD?

Answer 9

Older age
Hypertension
Diabetes
Smoking
Medications eg NSAIDs

Question 10

How does CKD present? (8)

Answer 10

Usually asymptomatic

Pruritus |
Anorexia |
Nausea |
Oedema |
Muscle cramps |
Peripheral neuropathy |
Pallor |
Hypertension

Question 11

How is CKD diagnosed?

Answer 11

2 x eGFR results 3 months apart

Proteinuria (urine albumin:creatinine ratio)