RRAPID AKI

Question 1

What is the definition of AKI? (3)

Answer 1

1. rise in serum creatinine > 26 umol/l within 48 hrs
2. 1.5-1.9 x greater than the baseline serum creatinine
3. urine output less than 0.5ml/kg/hr for 6-12 hours

Question 2

Symptoms (4)

Answer 2

1. hypovolemia
2. palapble bladder soemtimes
3. signs of vasculitis
4. bruits - renal artery stenosis

Question 3

Investigations (5)

Answer 3

1. FBC, U&Es, Bicarb, LFTS, Ca, phopshate
2. blood cultures
3. urine dipstick
4. CXray
5. US

Question 4

ABCDE

Answer 4

S- sepsis

T- toxins

• stop nephrotoxic drugs

O - optimise BP

P - prevent harm

• treat complications
  e. g. hyperkalemia, pulomanry oedema. acidosis, pericarditis

MONITOR URINE OUTPUT!!!

Question 5

When do you refer for renal replacement therapy?

Answer 5

• intractable hyperkaelemia
• PH < 7.15
• intractable pulmonary oedema
• uraemic pericarditis
• encephalopathy

Question 6

What do you need to monitor? (4)

Answer 6

1. daily volume assessment
2. fluid balance
3. U&Es
4. bicarbonate