RENAL FAILURE

Question 1

What results in a sudden decrease in kidney function and is characterized as an increase in serum creatinine?

Answer 1

Acute Kidney Injury (AKI)

Question 2

What results in an inability to maintain acid-base, fluid, and electrolyte balance and to excrete nitrogenous wastes?

Answer 2

Acute Kidney Injury (AKI)

Question 3

AKI can be divided into what three categories?

Answer 3

1. Prerenal
   a. Kidney hypoperfusion (low blood flow/pressure) leading to decreased
   GFR
2. Intrinsic kidney disease
3. Post renal
   a. obstructive uropathy

Question 4

What is the first step to treating a patient with AKI?

Answer 4

Identifying the cause

Question 5

What is the MOST common etiology of AKI and accounts for 40-80% of cases?

Answer 5

Prerenal

Question 6

If hypoperfusion in prerenal AKI persists it can lead to what?

Answer 6

Secondary intrinsic kidney injury

Question 7

Decreased renal perfusion occurs in several ways including what?

Answer 7

1. Decreased intravascular volume
2. Change in vascular resistance
3. Low cardiac output

Question 8

What is the least common cause of AKI (5-10%) of cases with causes including the following

1. Urethral obstruction
2. Bladder dysfunction or obstruction
3. Obstruction of both ureters/renal pelvises
4. BPH
5. Cancer

Answer 8

Post renal

Question 9

What form of AKI accounts for up to 50% of the cases and is considered after prerenal and post renal causes are ruled out?

Answer 9

Intrinsic

Question 10

These are signs and symptoms of what?
1. buildup of waste products can cause nonspecific symptoms and signs
termed uremia
a. nausea, vomiting, altered sensorium, pericarditis, malaise
2. Pericardial effusion
3. Arrhythmias
4. Rales in hypovolemia
5. nonspecific diffuse abdominal pain and ileus
6. may have signs and symptoms of the underlying disease causing their AKI
7. may be hyper or hypovolemic

Answer 10

AKI

Question 11

True or False

The ratio of BUN creatinine can help determine prerenal, postrenal, or intrinsic AKI

Answer 11

True

Question 12

What is the treatment for Prerenal AKI?

Answer 12

1. Depends on the cause
   a. restoring renal perfusion
2. avoiding nephrotoxic drugs

Question 13

What is the treatment for Postrenal AKI?

Answer 13

1. Bladder catheterization

2. Relieve underlying cause

Question 14

What is the treatment for Intrinsic kidney disease?

Answer 14

1. Usually self limited

2. managed by nephrology

Question 15

True or False

Most patients with AKI will be a medevac and follow ups are dependent on the underlying cause

Answer 15

True