Acute kidney injury Flashcards
What are the functions of the kidney?
-Elimination of toxins
-Regulation of acid
-Regulating mineral levels
-Monitors blood pressure
-Regulation of erythrocyte production
How can kidney function be assessed?
-Urine output and urinalysis
-Assessment of serum using urea and electrolytes
-GFR and creatinine clearance
What is the difference between AKI and CKD?
Chronic kidney disease happens over months, acute is very sudden
What is KDIGO staging?
Used to stage AKI
What are the 3 types of cause of AKI?
Pre-renal
-sudden and severe drop in BP or interrupted blood flow to the kidney from severe illness
Intrarenal
-Direct damage to the kidney by inflammation, toxins, drugs, infection, or reduced blood supply
Postrenal
-Obstruction
What are the risk factors for pre renal AKI?
Age
Diabetes
Liver disease
Heart failure
Hypertension
Chronic kidney disease
Male gender
Hypovolaemia
Sepsis/infection
Medication
What are some intrinsic causes of AKI?
-Glomerular/vascular
Eg. Rapidly progressive glomerulonephritis, HUS
-Tubulo-interstitial
Eg. Drugs: aminoglycosides, Lithium, Rhabdomyolysis, multiple myeloma
What are some causes of obstructive AKI?
Benign prostate hypertrophy
Bladder tumours
Pelvic tumours
Renal stones
Congenital defects
Drugs Eg. anticholinergics
What are the consequences of AKI?
Chronic kidney disease
end stage renal failure
Independent risk factor for mortality
What are the 2 types of IV fluids?
Crystalloids and
Colloid
Crystalloids have small molecules, are cheap, easy to use, and provide immediate fluid resuscitation, but may increase oedema.
Colloids have larger molecules, cost more, and may provide swifter volume expansion in the intravascular space, but may induce allergic reactions, blood clotting disorders, and kidney failure
What are the clinical manifestations of hyperkalaemia?
Nothing
Muscle weakness
Paralysis
Cardiac arrhythmias
ECG changes
Eg. broad QRS, peaked T waved, missing P wave
What is the treatment for hyperkalaemia?
-Redistribute
-insulin, dextrose, bicarbonate, beta agonists
-Remove from body
Reduce absorption from GI tract (Ca resonium)
What is calcium gluconate used for?
It stabilises the heart
Can be given in hyperkalaemia to reduce arrhythmias
