Week 7- Renal Therapeutics Lecture Flashcards
How might you treat acute kidney injury?
- Discontinue nephrotoxic Drugs/ Start antidote Therapy
- Start IV fluid therapy
- Rehydrate within 4-6 hours
- Provide maintenance
- Correct acid-base abnormalities
When should you not use diuretics in AKI?
If bladder is blocked
What happens if you dont excrete phosphate?
parathyroid hormone increases
What are the goals of renal diets?
Slow progression of CKD and prolong survival
Prevent clinical consequences of CKD including signs of uraemia
Adequate nutrition
Minimize derangements of electrolyte, calcium + phosphorus, acid-base balance
SPAM acronym
What is reduced in a renal diet?
Protein (‘high quality’), phosphate and sodium
What is increased in a renal diet?
Potassium, Vitamin D, omega-3-polyunsaturated fatty acids
* Neutralizing effect on systemic pH
What is the function of phosphate binders?
reduce the absorption of dietary phosphate in the gut- therefore decreasing serum phosphate
How would you treat uraemic gastritis?
nausea & vomiting, inappetence
- Reduce stomach acid secretion e.g. with omeprazole (PPI)
or famotidine/ranitidine (H2 antagonists)
- Address vomiting e.g. with maropitant (NK1
receptor antagonist)
- Improve appetite e.g. with mirtazapine (benzodiazepine)
How would you treat hypokalaemia?
Give oral supplementation with potassium gluconate or potassium citrate
How would you treat Anaemia?
- Human recombinant erythropoietin (but not approved for veterinary use)
- Blood transfusion
How would you treat Metabolic acidosis?
Supplement with oral sodium bicarbonate, (potassium citrate if hypokalaemic)
How might you treat CKD with chronic arthritis?
Typically treated with NSAIDs which are contraindicated in renal disease
- Use drugs with less renal toxicity if possible
