Renal failure

Question 1

Criteria for stage 1 AKI

Answer 1

At least >1.5-2x increase in serum creatinine from baseline

> 25mmol/L increase in Cr within 24 hours

Urine output 0.5ml/kg/hr for 6+ hours.

Question 2

Criteria for stage 2 AKI

Answer 2

Serum creatinine
- 2-3x increase from baseline

Urine output <0.5ml/kg/hr for 12 hours

Question 3

Criteria for stage 3 AKI

Answer 3

Serum creatinine
- At least 3x increase from baseline
- At least 354mmol/L increase

Urine output
- <0.3ml/kg/hr for 24 hours
- Anuria for 12 hours

Question 4

Pre-renal causes of AKI

Answer 4

Hypovolaemia
- Dehydration (i.e. vomiting, diarrhoea)
- Haemorrhage

Reduced perfusion
- Circulatory shock
-

Question 5

Renal causes of AKI

Answer 5

Nephrotoxins
- Antibiotics, NSAIDs & other medications

Acute tubular necrosis and interstitial nephritis

Infection

Glomerulonephritis

Rhabdomyolysis

Question 6

Post-renal causes of AKI

Answer 6

Ureteric obstruction
- Renal stones
- Renal strictures
- Compressive structures

Urethra obstruction
- BPH, prostate cancer

Neurogenic urinary retention

Question 7

U+E findings in AKI

Answer 7

Raised Cr and urea

Hyperkalaemia

May show deranged Na depending on cause

Question 8

What medication can exacerbate AKI

Answer 8

Metformin

Digoxin

Lithium

Question 9

Indications for renal transplant in AKI

Answer 9

Hyperkalaemia

Metabolic acidosis

Complicated uraemia

Fluid overload