AKI Flashcards
1
Q
What is the definition of AKI?
A
Failure of renal excretory function due to reduction of the GFR
Abrupt sustained rise (for 1-7 days being longer than 24 hours) in serum urea and creatinine
Creatinine from >1.5 times from baseline
Urine output from <0.5mL/kg/h >6h
2
Q
How common is AKI?
A
15% of adults admitted to hospital develop AKI
3
Q
What is the pathophysioloyg of AKI’s?
A
- GFR is controlled by prostaglandins and angiotensin II
- Leads to failure of:
- Erythropoietin production
- Vitamin D hydroxylation
- Regulation of acid base balance
- Regulation of salt and water balance
- Blood pressure control
- Classified as prerenal, renal or postrenal
4
Q
What are the risk factors/aetiology of AKI?
A
- Post surgery
- Pre-renal failure:
- Fluid depletion
- Hypotension
- Impaired cardiac pump efficiency
- Vascular disease limiting renal flow
- NSAIDs
- ACE inhibitors
- Renal:
- Systemic infection
- Nephrotoxic drugs
- Renal parenchymal disease
- Post renal:
- Enlarged palpable kidney/bladder
- Large prostate
- Pelvic masses
5
Q
What are the sign/symptoms of AKI?
A
↓ in excretion of nitrogenous waste – normally urea is measured • Weakness • Fatigue • Anorexia • Pruritis • Bruising • Nausea/vomiting • Breathlessness – due to anaemia and pulmonary oedema • Metal confusion • Seizures • Coma
6
Q
What investigations are conducted for suspected AKI?
A
- FBC
- ↓ RBC
- ↑ ERS
- U&E’s
- ↑ Urea
- ↑ Creatinine
- ↑ potassium
- ↑ HCO3 = metabolic acidosis
- ↓ Ca
- ↑ phosphate
- eGFR
- Urine dipstick
- ↑ specific gravity in pre renal
- ↓ Na in intrinsic
- US
- Renal biopsy – for unexplained AKI
7
Q
What are the surgical treatments for AKI?
A
- Catheter
* Dialysis/haemofiltration
8
Q
What are the pharmacological treatments for AKI?
A
- Fluids
* Blood transfusion
9
Q
What are the non pharmacological treatments for AKI?
A
- Enteral nutrition
- Restrict Na and K
- Avoid nephrotoxic drugs
