Renal Flashcards
Phases to ATN
Oligouric
Polyuric
Recovery phase
Causes of ATN
Ichaemia from no perfusion
Toxins
- rhabdo
- aminoglycosides
- contrast
- lead
What does haematuria at the end of micturition suggest
A distal cause
What is preferred investigation for proteinuria in CKD
Albumin creatinine ratio
When treat proteinuria with an ACEi
Over 3 with DM
Over 30 with coexistent HTN
Over 70 regardless
What medications can be used to manage patients with proteinuria
ACEi
SGLT-2 inhibitors
Which drugs have to stop in AKI
Diuretics
ACEi
ARB
NSAIDS
Aminoglycosides
What dose aspirin is acceptable to stay on in an AKI
75mg
RFs for AKI
DM
The failures- liver, heart
Drugs- ACEi- ARB, diuretics
Contrast agents
What counts as oligouria
<0.5ml/kg/hour for 6 hours
What do if no identifiable cause for AKI
Involve renal
Do USS
Investigations for AKI
All patients should have U&Es monitored and urine dip done
If no identifiable cause do an USS
What drugs can be used to remove potassium from body
Calcium resonium
Loop diuretics
Which drugs can be used too shift potassium intracellularly
Combined dextrose and insulin
Nebulised salbutamol
Management of hyperkalaemia
First to protect the cardiac membrane
- IV calcium gluconate
Short term intracellular shift
- dextrose/insulin
- nebulised salbutamol
Removal of potassium from body
- calcium resonium
- loop diuretics
- dialysis
Indications for dialysis in AKI
Refractory hyperkalaemia
Pulmonary oedema
Acidosis
Uraemia with complications- pericarditis, encephalopathy
Which complications of uraemia indicate dialysis
Pericarditis
Encephalopathy
Investigations for anti-GBM
Anti-GBM antibodies
Renal biopsy- linear IgG depostion on BM
Increased transfer factor in lungs
Presentation of goodpastures
Pulmonary haemorrhage
Rapidly progressive glomerulonpehritis
Management of CKD anaemia
Options include iron, EPO agents like darbepoetin or EPO and haemodialysis
Presentation of acute interstitial nephritis
Fever
Rash
Arthralgia
Renal problems
MCS of acute interstitial nephritis
Sterile pyuria
White cell casts
Most likely cause of peritonitis on peritoneal dialysis
Staph epidermis
How manage hyperphosphataemia in CKD
Initially reduce dietary phosphate
Second line- phosphate binders