RRAPID AKI

Question 1

AKI definition

Answer 1

Rapid reduction in kidney function

Hours to days
Spectrum of injury

Based on: creatinine rise, decrease in urine output

Question 2

increased serum creatinine associated with

Answer 2

higher morbidity and mortality

Question 3

Diagnosis of AKI

Answer 3

serum creatinine rises by ≥ 26µmol/L from the baseline value within 48 hours

or

serum creatinine rises ≥ 1.5 fold from the baseline value which is known or presumed to have occurred within one week

or

urine output is 6 consecutive hours

Question 4

staging of AKI

Answer 4

SCr increases and urine output decreases

Question 5

causes of SCr increase

Answer 5

Sepsis
Toxins
Low BP

Question 6

Causes of AKI - pre-renal

Answer 6

sepsis, toxins, hypotension, hepatorenal syndrome, renal artery stenosis

Question 7

Causes of AKI - intrinsic

Answer 7

Acute tubular injury
Tubulointerstitial injury
Glomerulonephritis
Myeloma
Lupus nephritis
Vasculitis (ANCA)
Haemolytic uraemic syndrome (HUS)
Thrombotic thrombocytopenic purpura (TTP)

Question 8

Causes of AKI - post-renal

Answer 8

Kidney stones
Prostatic hypertrophy
Tumours
Retroperitoneal fibrosis

Question 9

STOP AKI

Answer 9

Sepsis
Toxins - avoid
Optimise BP
Prevent harm

Question 10

AKI complications

Answer 10

acidosis

hyperkalaemia

Question 11

Red flag sepsis

Answer 11

Systolic BP 2mmol/l
Heart rate >130 per min
Resp. rate >25 per min
Oxygen sats

Question 12

BUFALO

Answer 12

Bloods
U&Es
Fluids
Atx
Lactate
Oxygen

Question 13

how to optimise BP

Answer 13

Assess fluids - oral fluids and IV fluids

If hypotensive withhold antihypertensives, diuretics

Consider vasopressors

Question 14

Example of vasopressor

Answer 14

Noradrenaline