2: Acute Renal Failure Flashcards Preview

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Flashcards in 2: Acute Renal Failure Deck (22):
0

Azotemia

Dx by the amount of nitrogenous waste

1

Uremia

There is a sx of high nitrogen in blood

2

Significant serum Creatinine increase

0.5mg/dL increase over 24hrs

3

Exotoxin causing Acute tubular necrosis

Cisplatin
Ethylene glycole
Cyclosporine
Aminoglycoside (7-10 days)**
Radiocontrast dye (24-48hrs)**

4

Endotoxin causing Acute tubular necrosis

Calcium
Light chains of MS
Myoglobin
Hemoglobin
Uric acid

5

Damage to Interstitium

Drug/Allergy (penicillin)
Infection (Legionnaire disease, Hantavirus)
Infiltration (Sarcoidosis, Lymphoma/Leukemia)
Autoimmune (SLE)

6

Prerenal Azotemia- cause

Hypovolumia

7

Cause of Acute renal failure-post renal to accumulate crystals (ATM)

Acyclovir
Methotrexate
Triemetrine

8

Granular cast- "Muddy brown"

ATN

9

Hyaline cast

Benign. Could be by anything

10

RBC cast

Glomerulonephritis

11

WBC cast

Pyelonephritis
Acute infective interstitial nephritis

12

Eosinophilic cast

Acute allergic interstitial nephritis

13

Prerenal ARF

Retain sodium and water
BUN is reabsorbed more than creatinine-> BUN/Creatinine ratio is high >20
FeNa:500

14

Renal ARF

BUN/Creatinine ratio is low
FeNa: >2%
Osm <20

15

Complications

Metabolic acidosis
Hyperkalemia
Hyponatremia
Hypervolumia
Hyperphosphatemia
Hypocalcemia

16

Management

Stop the insult
Correct volume
Hydration (watch out for over hydration)
Correct electrolytes
Some drug (Furosemide, Dobutamine, Ca channel blocker)

17

Hypovolumia- causes

-Hemorrhage
-Dehydration
-Burns
-GI loss: vomiting, diarrhea
-Replaced in other space: ascites, peritonitis

18

Acute glomerulonephritis or vasculitis- cause

RPGN

19

Acute Tubular Necrosis- causes

Ischemia
Toxins

20

Clinical course in ATN

Initial phase: Oliguria (400mL/day)

21

Postrenal ARF

MC: Obstruction bladder neck
*Above the bladder to cause ARF, it must be BILATERAL**