What is the definition of AKI?
increase in serum creatinine (>26.4)
increase in creatinine by 50%
reduction in urine output
one of the above
What needs to be done before you can diagnose a patient with AKI?
Attempt fluid resuscitation
What are some pre-renal causes of AKI?
Hypotensive (cardiogenic, septic, anaphylactic)
What are the definitions of
a) normal urine output
b) < 0.5ml/kg/hr
If patients are sick (e.g diarrhoea, vomiting), which drugs should they stop to prevent AKI?
e.g ACE inhibitors, ARBs, diuretics
What happens if pre-renal AKI isn't treated?
Acute tubular necrosis
What commonly causes pre-renal AKI?
Hypovolaemia, hypotension due to
What are signs and symptoms of dehydration?
Low urine output
Cap refill > 2s
How is pre-renal AKI treated?
Fluid challenge for hypovolaemia and hypotension
500ml 0.9% NaCl over and over until improvement
What are some
causes of renal AKI?
a) Vasculitis, renovascular disease (renal artery stenosis)
Which drugs can cause nephritis?
What are the symptoms of AKI?
Constitutional - anorexia, weight loss, fatigue..
Which infection commonly causes glomerulonephritis?
What types of GN are suggested by
a) sore throat in the past 2-3 weeks
c) joint pain
a) Post-streptococcal glomerulonephritis
b) Vasculitic nephritis
c) Lupus nephritis
d) Goodpasture's syndrome
Why can compartment syndrome cause AKI?
What are some blood tests which should be done for those with AKI?
U&Es - particularly hyperkalaemia
FBC - for anaemia, prolonged clotting
What's a quick test which can be done to pick up proteinuria / haematuria?
What imaging is first line for looking at the kidney?
What can it pick up?
Which causes of AKI are associated with
c) GBM antibody?
a) SLE (not really)
b) Small vessel vasculitis
c) Goodpasture's syndrome
What are signs of multiple myeloma on blood test?
When would a renal biopsy be indicated?
Rapidly progressing GN
Positive antibodies for something
Don't know what's wrong
Which scan is used to guide renal biopsies?
What are some signs of life-threatening AKI?
Resistant fluid overload (pulmonary oedema with no urination)
Severe metabolic acidosis
What causes post-renal AKI?
Obstruction of urinary tract
What problem is caused by an obstructed urinary tract?
How does hydronephrosis cause AKI?
Loss of kidney's ability to concentrate urine
What can cause obstruction of the urinary tract?
What is a life-threatening electrolyte imbalance caused by AKI?
What causes death in hyperkalaemia?
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