Renal 2 (Week 13) Flashcards
What causes prerenal AKI
reduced blood perfusion of kidney
what causes reduced blood perfusion to kidneys
arterial hypotension
dehydration
sepsis
arterial occlusion (plaques, air bubbles, fat globules)
administration of ACE inhibitors or ARB meds
what do NSAIDs do
inhibit production of all types of prostaglandins
intrinsic AKI
damage to structures within the kidney
most common cause of intrinsic AKI
acute tubular necrosis
what causes acute tubular necrosis
renal ischemia
shock syndrome
causes of intrinsic AKI
acute tubular necrosis exposure to toxins such as -myoglobin -contrast dyes -aminoglycosides -infections (TSS) - auroimmunity -other pharmaceuticals
postrenal AKI due to
obstruction of flow in urinary system
causes of postrenal AKI
prosttatic hypertrophy or cancer
infection
improperly placed urinary catheter
nephrolithiasis (kidney stone)
primary means to determine presence of AKI
serum creatinine
urine output
other tests used to detect AKI
urine sedimentation urine osmolality and electrolytes serum electrolytes urinary specific gravity microscopic eval of urine blood urea nitrogen
what would you look for in microscopic eval of urine
bacteria
pieces of dead cells
-indicates infection or breakdown of cells (usually renal tubular cells)
blood urea nitrogen more useful for
monitoring chronic kidney disease
what happens as BUN levels increase above normal?
GFR decreases below normal
albuminuria
albumin (protein) in urine
how is chronic kidney disease defined (CKD)
abnormalities in kidney structure or function present for 3 months or longer
structural abnormalities seen in chronic kidney disease
albumuria
hemaaturia
presence of red cell casts
electrolyte abnormalities
what indicates a functional abnormality in CKD
drop in GFR