Renal Facts Flashcards
CKD STAGE 1
GFR greater than 90
Define stage 1 AKI
Creatinine rise 1 to 1.5x baseline OR a rise of 26.5 umol/L (0.3g/dL)
Urine 0.5 ml/kg/hr for 6-12 hrs
Stage 2 AKI
Creatinine 2 - 2.9x baseline
Urine 0.5ml/kg/hr for 12 hours
Stage 3 AKI
Creatinine 3x baseline or a rise of 353.6 umol/L (4mg/dL)
Urine of 0.3 ml/kg/hr for more than 24 hours
Or
Anuria for 12
Rifle - Risk
Creatine 1.5x
GFR decrease by 25%
Urine 0.5 ml/kg/hr for 6 hours
Rifle - injury
Creatinine 2x baseline
GFR decrease by 50%
Urine 0.5 for 12 hours
Rifle - failure
Creatinine 3x base
GFR decrease by 75%
Or creatinine greater than 4mg/dL
Urine 0.3 mls/kg/hr for 24 hours
Anuria for 12
Rifle - loss
Persistent ARF WITH complete loss of function for more than 4 weeks
Rifle - end stage
End stage disease for more than 3 months
CKD stage 2
60-89
CKD stage 3
30-59
CKD stage 4
15-29
CKD stage 5
Less than 15 mls/min/1.73 m2 body area
Causes of a normal anion gap metabolic acidosis
Diarrhoea Ileostomy Renal tubular acidosis Parenteral nutrition Colonic ureteric implant/diversion
Causes of a raised anion gap metabolic acidosis
Lactic acidosis Ketoacidosis - diabetes, starvation, alcohol excess AKI/CKD Methanol Ethylene glycol Salicylate poisoning
Anticoagulation methods in RRT
Unfractionated heparin - 2litres crystalloid wth 5000 units heparing
Infuse at 5-10 IU/hour aiming for APTT ratio of 1.5-2
Prostacyclin PGI2. Inhibits platelet aggregation. Short acting, minimal systemic effects
Citrate - chelates calcium, reducing clotting cascade and platelet aggregation. Calcium infused as it leaves the filter
Citrate returning to the body is metab to bicarb in the liver
What is the required APTT ratio for heparinisation
1.5-2
Indications for RRT
Classic: Symptomatic uraemia Rapidly climbing urea and creatinine Refractroy K Severe met acid Refractory pulm oedema Oliguria
Non renal Fluid balance - cardiac failure Toxin clearence Electrolytes correction Temp control Cytokines
