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Flashcards in 13 - AKI Deck (15):
1

azotemia

accumulation of nitrogenous waste

2

polyuria amt

>3 L/d

3

oliguria and anuria amt

oliguria <50 ml/d

4

2 most likely causes of anuria

urinary tract obstruction
vascular disaster causing no RBF

5

prerenal state definition

homeostasis maintained, but dec GFR
fall in capillary pressure, dec glomerular surface area
inc reabs by tubules
RAS, aldo, ADH, SNS activated

6

prerenal failure

prerenal state except now homeostasis is lost
still no permanent damage

7

prerenal etiologies

dec vascular volume: bleeding, GI loss, diarrhea, diuresis
ineffective circulating volume: sepsis, heart failure, shock, liver failure, pre-eclampsia

8

how do you distinguish prerenal state vs intrinsic kidney damage

prerenal will:
have higher BUN:creatinine ratio (~20:1)
nl urinalysis (instead of cellular material, RBCs or WBCs)
very low urine Na
low FeNa
high urine osmolarity

9

diseases that cause prerenal failure

hepatorenal failure
RAS
NSAIDs (need PGs for renal regulation when volume depleted)
CHF

10

acute tubular necrosis pathophys

caused by multiple renal insults (preexisting damage, prerenal state, nephrotoxin or ischemia)
cells in tubules die, sloughed off in urine as casts
inflammatory mediates extend damage
recovery in 1-3 wks

11

nephrotoxins that cause ATN

iv contrast
heme pigments (myoglobin, hemoglobin)
certain abx (aminoglycosides)
heavy metals (like cisplatin)
carbon tetrachloride and solvents

12

cortical necrosis

causes patchy damage, some renal fn may remain
due to obstetrical disasters, DIC, HUS
anuria or oliguria common

13

papillary necrosis

long loops of henle, vasa recta, collecting ducts affected
flank pain w/ tissue in urine
often due to sickle cell, analgesic abuse, pyelonephritis
not usually oliguric or anuric
impairs ability to concentrate urine

14

uremia

sx associated w/ high amts of nitrogenous waste in blood
lethargy, nausea, sour taste, altered mental status, seizures

15

complications of AKI

uremia
loss of volume/BP regulation > overload > cardio/pulm failure
electrolyte abnormalities
acidemia
bleeding