SA Acute Kidney Injury Flashcards
What is azotemia?
Increased urea +/- creatinine in the blood
What is uraemia?
The clinical syndrome arising from azotemia
What may a pre-renal azotemia be due to?
Reduction in renal blood flow, increased protein catabolism or GI haemorrhage.
How would you diagnose a pre-renal azotemia?
Azotemia with concetrated urine. (Kidneys are trying to conserve water)
What is the cause of a renal azotemia?
Fewer functional nephrons
How would you diagnose a renal azotemia?
Azotemia with dilute urine
What may cause a post-renal azotemia?
Urinary tract obstruction
Urinary tract rupture
How would you diagnose a uroabdomen?
[creatinine]fluid > [creatinine]serum
What are two clinical signs usually seen with severe AKI?
Anuria or oliguria
List four physiologic consequences of AKI
Failure of excretion of nitrogenous waste products
Acid-base disturbances
Electrolyte disturbances
Fluid balance disturbances
List three infectious aetiologies of AKI.
Leptospirosis
Pyelonephritis
CRGV
Which disease should you rule out in the diagnosis of AKI in dogs?
Addison’s disease
List four specific urinalysis findings of AKI
Submaximally concentrated urine
Sediment examination - casts/crystals
Cytological examination
Bacterial culture and sensitivity
Where may renal cytology (FNA) be indicated?
Where there is a suspected lymphoma.
How should you correct hypovolaemia in dogs or cats?
10ml/kg (dog), 5ml/kg (cat) over 10-15 minds
What are the risks with anuria/oliguria?
Progressive azotemia, metabolic derangements, life threatening increases in potassium. Volume overload will also worsen the outcome.
What is the normal urine output for dogs/cats on fluids?
1-2 ml/kg/hr
What three things will you seen on an ECG where there is hyperkalaemia?
Wide QRS
Flattened P
Spiked T
When may you use Ca Gluconate IV?
In hyperkaleamia management, not to address the hyperkalaemia but to stabilise the cardiomyocyte membranes.
What can you use to manage hyperkalaemia?
Glucose +/- exogenous insulin to redistribute the potassium intracellularly.
What are the values of normotension in dogs and cats?
120-140mmHg
What drug should you use for NSAID induced AKI?
Misoprostol
What drug should you use for AKI caused by pyelonephritis?
Antibiotics - clavulanate potentiated amoxicillin
What drug should you use for AKI cause by ethylene glycol poisoning?
Ethanol
How would you manage nausea in AKI?
Maropitant
Metoclopramide
What are the indications for renal replacement therapy?
Persistent anuria
+/- volume overload
+/- unmanageable hyperkalaemia
