Step Up: AKI

Question 0

Most common clinical finding patients with AKI?

Answer 0

Weight gain and edema

Question 1

RIFLE criteria?

Answer 1

Risk 1.5 fold increase in creatinine for 6 hours
Injury: 2 fold increased creatinine for 12 hrs
Failure: 3 fold increase in creatinine for 24 hrs
Loss: Complete loss of function 4+ weeks
ESRD: Complete loss of function 3+ months

Question 2

Most common cause of death in a AKI?

Answer 2

Infection (75%)

Cardiorespiratory complications

Question 3

Causes of hypovolemia?

Answer 3

Dehydration
Excessive diuretics
Vomiting
Diarrhea
Burns
Hemorrhage

Question 4

Suspect patient is in prerenal failure – expect?

Answer 4

1. Oligoria
2. BUN:Cr >20:1
3. Increased urine osmolality >500
4. Decreased urine sodium <20

Question 5

Causes of intrinsic renal failure?

Answer 5

1. ATN (ischemia, nephrotoxins)
2. Glomerular disease (Wegner’s, poststreptococcal GN, Goodpasture’s, lupus)
3. Vascular (renal artery occlusion, TTP, HUS)
4. Interstitial disease (hypersensitivity reaction)

Question 6

Findings of rhabdomyolysis?

Answer 6

Acute kidney injury due to myoglobin toxicity

Increased CPK
Hyperkalemia
Hypocalcemia
Hyperuricemia

Question 7

Treatment of rhabdomyolysis?

Answer 7

1. IV fluids
2. Mannitol
3. Bicarbonate (drives K back into cells)

Question 8

Causes of nephrotoxic acute kidney injury?

Answer 8

1. Antibiotics (aminoglycosides, Vancomycin)
2. Radiocontrast
3. NSAIDs
4. Myoglobinuria
5. Hemoglobinuria
6. Cisplatin
   7 Kappa abd Gamma light chains from multiple myeloma

Question 9

Expected findings in interstitial acute kidney injury?

Answer 9

1. Oliguria

2. BUN:Cr40