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Pathopharmacology I > Wk 3 Acute Kidney Injury > Flashcards

Wk 3 Acute Kidney Injury Flashcards

1
Q

What does acute kidney injury result from?

A

Ischemic injury

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2
Q

What can cause ischemic injury?

A

Volume depletion and decreased perfusion
Toxic injury from chemicals
Sepsis

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3
Q

The ischemic injury initiations what 3 responses?

A

Inflammatory
Vascular
Cell death

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4
Q

What are the 3 classifications of AKI?

A

Prerenal
Intrarenal
Postrenal

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5
Q

Prerenal means

A

before the kidney

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6
Q

The most common cause of pre renal AKI

A

inadequate perfusion

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7
Q

What are causes of inadequate perfusion? (6)

A 
Hypotension
Hypovolemia
Sepsis
Decreased CO
Renal vasoconstriction
Renal artery stenosis
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8
Q

What is renal artery stenosis?

A

Narrowing of one or more arteries that carry blood to your kidneys

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9
Q

What else can cause inadequate perfusion to the kidneys?

A

Contrast agents that are nephrotoxic

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10
Q

In pre renal AKI, the GFR is

A

decreased

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11
Q

Why is the GFR decreased in pre renal AKI

A

due to low glomerular filtration pressure

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12
Q

What can cause ischemic cell injury and necrosis?

A

Failure to restore BV, BP, and O2 delivery

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13
Q

What is intra renal AKI?

A

Injury occurs IN the kidney

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14
Q

What is the most common cause of intrarenal AKI?

A

acute tubular necrosis (ATN)

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15
Q

What is acute tubular necrosis related to? (4)

A

Prerenal AKI
Nephrotoxic agents
Acute glomerulonephritis
Vascular disease

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16
Q

Prerenal AKI can become…

A

Intrarenal AKI

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17
Q

__ and __ cause ischemia and inflammatory response in kidney

A

Hypotension and hypovolemia

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18
Q

What 4 things can cause nephrotic acute tubular necrosis?

A

Abx
Heavy metals
Contrast dye
Rhabdomyolysis

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19
Q

What antibiotics can cause nephrotic acute tubular necrosis?

A

aminoglycosides

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20
Q

What do you see with rhabdomyolysis?

A

Breakdown of skeletal muscle and release of excessive myoglobin

21
Q

What causes the damage to the kidneys in rhabdomyolysis?

A

The release of excess myoglobin

22
Q

What type of injury can cause rhabdomyolysis?

A

Crush injuries

Drug overdose

23
Q

What is post renal AKI?

A

Rare condition that occurs with urinary tract obstruction

24
Q

5 causes of post renal AKI

A 
Bladder outlet obstruction
Prostatic hyperplasia
Bilateral ureteral obstruction
Tumor
Neurogenic bladder
25
Q

What does the obstruction cause in post renal AKI?

A

Increased renal pressure proximal to the obstruction

26
Q

How fast does AKI occur?

A

within hours

27
Q

What would the GFR be in AKI?

A

Decreased

28
Q

What is a normal GFR?

A

Greater than 90

29
Q

What is a normal urinary output?

A

Greater than 30mls/hr

30
Q

What would the urinary output be in AKI?

A

Decreased

31
Q

What would the BUN be in AKI?

A

Increased

32
Q

What is a normal BUN?

A

10-20 mg/dL

33
Q

What is a normal creatinine?

A

0.5-1.2 mg/dL

34
Q

What would be the creatinine be in AKI?

A

Increased

35
Q

AKI may be…

A

reversible

36
Q

What is creatinine?

A

Chemical compound left over from energy production in the muscles

37
Q

What is urea nitrogen?

A

Byproduct of protein breakdown

38
Q

When does oliguria occur in AKI?

A

1 day after hypotensive event

39
Q

How long does oliguria last in AKI?

A

1-3 weeks

40
Q

Oliguria is defined as…

A

Less than 400 mls/24 hrs

41
Q

What is the goal of treatment for AKI?

A

Stabilize the patient until kidney function is returned

42
Q

What is important considering electrolyte imbalances in AKI?

A

Correct fluid imbalance and hyperkalemia

43
Q

What might be prescribed to increase potassium removal for treatment of hyperkalemia?

A

furosemide (Lasix)

44
Q

What helps move potassium back into the cells temporarily? (2)

A

Insulin

Dextrose

45
Q

What are 3 potassium binders we can give to move potassium through the GI tract?

A

sodium polystyrene sulfonate
patiromer
sodium zirconium cyclosilicate

46
Q

A patient with AKI will have what acid-base imbalance?

A

Metabolic acidosis

47
Q

What do we give to treat the acid-base imbalance for AKI?

A

Sodium bicarbonate

48
Q

What other 2 things to do for AKI

A

Manage BP

Avoid nephrotoxic drugs

Pathopharmacology I (33 decks)

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