Kidney 5 Flashcards
With prerenal injury, there is __________, but there is no ________
inadequate perfusion of the kidneys but not intrinsic damage
Treatment for prerenal injury includes
restoration of renal blood flow with IVF
hemodynamic support
& PRBCs
Intrinsic injury can be caused by injury of the
tubules, glomerulus or interstitial space
Causes of acute tubular necrosis include
ischemia and nephrotoxic drgus
Treatment of intrinsic injury is
supportive
The source of obstruction for postrenal injury can arise anywhere between
the collecting duct and the urethra
Treatment of postrenal injury is
to remove the obstruction
___________ does not prevent or treat AKI
renal dose dopamine
Attempting to convert oliguric to nonoliguric AKI with ______ increases the risk of additional renal injury as well as mortality
diuretics
The following patients are at risk for AKI during the perioperative period:
pre-existing kidney disease
sepsis
jaundice
prolonged renal hypoperfusion
CHF
advanced age
high-risk surgery (use of aortic cross clamp & liver transplant)
What is the RIFLE criteria?
risk
injury
failure
loss
end-stage kidney disease
Risk indicates
increased SCr to >1.5x baseline
UOP <0.5 mL/kg/hr for >6 hours
Injury indicates
increase in Scr to >2x baseline
UOP <0.5 mL/kg/hr for >12 hours
Failure indicates
increase in SCr to >3x baseline or increase >0.5 mg/dL to absolute value of >4 mg/dL
UOP <0.3 mL/kg/hr >12 or anuria >12 hr
Loss indicates
need for renal replacement therapy >4 weeks
End-stage indicates
need for renal replacement therapy >3 months
Prerenal injury can be a result of
intravascular volume depletion
decreased CO
systemic vasodilation
renal vasoconstriction
increased abdominal pressure
Intrinsic injury can be a result of
tubular injury
tubulointerstitial injury
glomerular injury
renal vasculature
large vessels
The risk of prerenal azotemia is reduced by
maintaining MAP >65 mmHg and providing appropriate hydration
