Renal Diseases

Question 1

define acute kidney injury (AKI)

Answer 1

a rapid and sustained reduction in renal function that causes oliguria and a rise in serum urea and creatinine

Question 2

describe stage 1 of AKI

Answer 2

a creatinine rise 1.5X baseline or urine output of <0.5ml/kg/hr for 6hrs

Question 3

describe stage 2 of AKI

Answer 3

a creatinine rise 2X baseline or urine output of <0.5ml/kg/hr for 12hrs

Question 4

describe stage 3 of AKI

Answer 4

a creatinine rise 3X baseline or urine output <0.3ml/kg/hr for 24hrs

anuria for 12hrs OR serum creatinint >354umol/dl

Question 5

risk factors of AKI

Answer 5

CKD 
>65yrs 
PMH of AKI 
co-exisiting illness 
hypovolaemia 
sepsis 
nephrotoxic medications

Question 6

clinical features of AKI

Answer 6

affected urine output
nausea + vomiting
dehydration
confusion

Question 7

signs of AKI

Answer 7

hypertension 
enlarged, painless bladder
raised JVP 
pulmonary or peripheral oedema 
pericardial rub

Question 8

bedside investigations of AKI

Answer 8

ECG
ABG
bloods
renal US

Question 9

further investigations of AKI

Answer 9

CXR
urine dip
glomerulonephritis screening

Question 10

management if pre-renal cause

Answer 10

give fluids if hypovolaemic
give IV antibiotics if septic
STOP nephrotic drugs

Question 11

management if renal cause

Answer 11

nephrology review and referral

Question 12

management if post-renal cause

Answer 12

catheterisation and urology review

Question 13

indications for acute dialysis in cases of AKI

Answer 13

acidosis 
electrolyte imbalance 
intoxication
oedema 
uraemia