Session 6- Acute Kidney Injury Flashcards
what is uraemia
clinical symptoms which arise when nitrogenous metabolic waste product accumulate in the blood as a result of decreased filtration of these products by the kidneys
what is AKI and what rises as an indication of it
the deterioation of renal function occurring over hours or days
urea and creatinine rise rapidly
pre-renal causes of AKI
reduced effective circulating volume- hypovolemia
shock
renal artery stenosis or emboli
NSAIDs and ACE inhibitors- impair the mechanisms of renal autoregulation so can predispose to prerenal AKI
intrinsic cause of AKI
acute tubular necrosis
acute interstitial nephritis
glomerular disease
vascular disease
what causes acute tubular necorosis
rhabdomyolosis
drug toxicity
toxins
ischaemia
what causes acute interstitial nephritis
drugs
infections
hypercalcaemia
multiple myeloma
post renal causes of AKI
bladder outflow obstruction
tumour
stone
retroperitoneal fibrosis causing ureteral obstruction
diagnostic approach of AKI
urine tests
blood tests
renal imaging
what biochemical changes occur during AKI
increased plasma urea and creatinine concentrations
increased plasma concentration of K+
metabolic acidosis and Increased anion gap
increased plasma phosphate
decreased plasma calcium
management of AKI
fluid replacement therapy to optimize blood flow
hypovolemia should be rapidly corrected with approproate IV fluid
how do you manage the obstrcution to bladder outflow
urinary or suprapubic catheter
if ureters are obstrcuted a nephrostomy os inserted above obstruction
