227: Acute Renal Failure Flashcards
Thiazides (e.g. chlorothiazide, indapamide) can cause…
hypokalemia. (inhibit Na-K-Cl transporter in distal convoluted tubule, if sodium isnt being retained potassium isnt entering blood stream) )
Loop Diuretics (e.g. bumetanide, furosemide) can cause…
hypokalemia ( inhibits Na-K-Cl cotransporter in the ascending limb)
ACE inhibitors (e.g. ramipril) cause…
hyperkalemia ( no ang 2 = no aldosterone from adrenals)
Ang receptor blockers (candersartan, losartan) can cause…
hyperkalemia (no aldosterone production)
Spirolactone is …
a potassium sparing diuretic therefore can contribute to hyperkalemia.
long term use causes renal damage…
aminoglycoside - gentamicin, NSAIDS (reduced prostaglanins from the distal tubule… so reduced perfusion and reduced renin from afferent arterioles…reduced aldosterone.
drug causing falsely elevated creatinine
Trimethoprim (antibiotic for urinary tract infection)
Drug that causes hypercalcaemia
Vit D and calcium
Drug causing high uric acid ( or urate stones)
chemotherapy drugs (cell break down - so lots of nucleic acid converted to uric acid for excretion)
drugs causing rhabdomyolysis
statins, calcineuin inhibitors ( cyclosporin/ tacrolimus)
how do statins cause rhabdomyolysis?
they cause muscle breakdown
how do calcineuin inhibitors cause rhabdomyolysis?
its a drug reaction…however they also cause vasoconstriction of the afferent arteriole.
What is rhabdomyolysis?
muscle breakdown releasing myoglobin - toxic to kidney.
when would you biopsy the kidney?
to look at the glomerulus and tubules. nephrotic syndrome, AKI, urinary abnormalitis and post transplant.
electrolyte imbalance associated with: MDMA
hyponatraemia
