7: Acute kidney injury Flashcards Preview

Renal Week 2 2017/18 > 7: Acute kidney injury > Flashcards

Flashcards in 7: Acute kidney injury Deck (36)
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1

What is the definition of AKI?

Abrupt (<48h):

increase in serum creatinine (>26.4)

increase in creatinine by 50%

reduction in urine output

one of the above

2

What needs to be done before you can diagnose a patient with AKI?

Attempt fluid resuscitation

Exclude obstruction

3

What are some pre-renal causes of AKI?

Hypovolaemia

Hypotensive (cardiogenic, septic, anaphylactic)

Certain drugs

4

What are the definitions of

a) normal urine output

b) oligouria?

a) 0.5ml/kg/hr

b) < 0.5ml/kg/hr

5

If patients are sick (e.g diarrhoea, vomiting), which drugs should they stop to prevent AKI?

Antihypertensives

e.g ACE inhibitors, ARBs, diuretics

6

What happens if pre-renal AKI isn't treated?

Acute tubular necrosis

7

What commonly causes pre-renal AKI?

Hypovolaemia, hypotension due to

sepsis

dehydation

Also:

drugs

rhabdomyolysis

8

What are signs and symptoms of dehydration?

Hypovolaemia

Tachycardia

Low urine output

Low JVP

Cap refill > 2s

Oedema

9

How is pre-renal AKI treated?

Fluid challenge for hypovolaemia and hypotension

500ml 0.9% NaCl over and over until improvement

10

What are some

a) vascular

b) glomerular

causes of renal AKI?

a) Vasculitis, renovascular disease (renal artery stenosis)

b) Glomerulonephritis

11

Which drugs can cause nephritis?

Antibiotics

PPIs

Gold, pencillamine

methotrexate

gentamicin

12

What are the symptoms of AKI?

Constitutional - anorexia, weight loss, fatigue..

N&V

Itch

Fluid retention

13

Which infection commonly causes glomerulonephritis?

GAS

14

What types of GN are suggested by

a) sore throat in the past 2-3 weeks

b) rash

c) joint pain

d) haemoptysis?

a) Post-streptococcal glomerulonephritis

b) Vasculitic nephritis

c) Lupus nephritis

d) Goodpasture's syndrome

15

Why can compartment syndrome cause AKI?

Rhabdomyolysis

16

What are some blood tests which should be done for those with AKI?

U&Es - particularly hyperkalaemia

FBC - for anaemia, prolonged clotting

17

What's a quick test which can be done to pick up proteinuria / haematuria?

Urinalysis

18

What imaging is first line for looking at the kidney?

What can it pick up?

USS

Stones

19

Which causes of AKI are associated with

a) ANA

b) ANCA

c) GBM antibody?

a) SLE (not really)

b) Small vessel vasculitis

c) Goodpasture's syndrome

20

What are signs of multiple myeloma on blood test?

Hypercalcaemia

Anaemia

21

When would a renal biopsy be indicated?

Rapidly progressing GN

Positive antibodies for something

Don't know what's wrong

22

Which scan is used to guide renal biopsies?

USS

23

What are some signs of life-threatening AKI?

Hyperkaleamia

Resistant fluid overload (pulmonary oedema with no urination)

Severe metabolic acidosis

Severe uraemia

24

What causes post-renal AKI?

Obstruction of urinary tract

25

What problem is caused by an obstructed urinary tract?

Hydronephrosis

26

How does hydronephrosis cause AKI?

Loss of kidney's ability to concentrate urine

27

What can cause obstruction of the urinary tract?

Renal calculi

Malignancy

Strictures

Prostate enlargement

28

What is a life-threatening electrolyte imbalance caused by AKI?

Hyperkalaemia

29

What causes death in hyperkalaemia?

Arrythmia

30

What is the normal range of potassium concentrations in the body?

What level is hyperkalaemic?

What level is life-threatening?

3.5 - 5.0

Hyperkalaemia: >5.5

Life-threatening hyperkalaemia: >= 6.5