Renal Function 2

Question 1

Define timing of AKI vs CKD

Answer 1

AKI = abrupt 
CKD = longstangding

Question 2

Define reversibility of AKI vs CKD

Answer 2

AKI = reversible 
CKD = irreversible

Question 3

What is treatment targeted to in AKI vs CKD

Answer 3

AKI = reversal of disease 
CKD = prevention of complication of CKS, limiting progression

Question 4

Define AKI

Answer 4

Rapid reduction in kidney function, leading to inability to maintain electrolyte, acid base and fluid haemostats

Question 5

How do you categorise AKI

Answer 5

Pre renal
Renal
Post renal

Question 6

What are causes of pre-renal AKI classified as

Answer 6

Due to REDUCED RENAL PERFUSION

• generalised reduction in perfusion (shock, hypovolaemia)
• selective renal ischaemia (renal artery stenosis, drugs)

Question 7

What are drugs that decrease renal blood flow, thereby causing reduced renal perfusion?

Answer 7

NSAIDS
Calcineurin inhibitors
ACE inhibitors, ARBs
Diuretics

Question 8

What can prolonged pre-renal AKI lead to?

Answer 8

Acute tubular necrosis (ischaemic injury)

Question 9

What is the hallmark of post-renal AKI

Answer 9

Physical obstruction off urine flow

Question 10

What are causes of post renal AKI

Answer 10

Intra renal obstruction 
Ureteric obstruction (BILAT)
Prostatic /urethral obstruction 
Blocked urinary catheter

Question 11

What are intrinsic renal AKI causers

Answer 11

Vascular disease e.g. vasculitis, amyloidosis
Glomerular disease e.g. glomerulonephritis
Tubular disease e.g. ATN
interstitial disease e,g. analgesic nephropèathy, from NSAIDS

Question 12

What are causes of direct tubular injury ?

Answer 12

TOXINS
Endogenous:
- myoglobin (rhabdomyolysis)
- immunoglobulins (myeloma)

Exogenous:
- Aciclovir

Question 13

What are 2 key measures to identify AKI

Answer 13

Creatinine (GFR)

Urineo Output

Question 14

How many stages of CKD are there?

Answer 14

5

Question 15

What are the most common causes of CKD?

Answer 15

DM
Atherosclerotic renal disease
Hypertension

Question 16

What are consequences of CKD?

Answer 16

Failure of homeostatic function

• acidosis
• hyperkalaemia

Failure of hormonal function

• anaemia
• renal bone disease

Cardiovascular disease

Uraemia, death

Question 17

How does CKD cause metabolic acidosis?

Answer 17

Failure of renal excretion of protons

Question 18

How do you treat metabolic acidosis in CKD=?

Answer 18

Oral sodium bicarb

Question 19

How does CKD cause anaemia?

Answer 19

Due to progressive decline of EPO producing cells with the loss of renal parenchyma

Question 20

What kind of anaemia does CKD cause

Answer 20

normocuytic normochromic

Question 21

HOW DO YOU treat CKD anaemia?

Answer 21

EPO injection (EPO alpha, beta, darbopoetin)

Question 22

What is the event most likely to kill someone with CKD?

Answer 22

CVD

due to excess off heavily clacified plaques depositing on the blood vessels

Question 23

What are 3 treatment options for those qwiutg progressive CKD?

Answer 23

Transplant
Haemodyalisis
Peritoneal dialysis