Acute Kidney Injury Flashcards
What are the definitions for stage 1, 2 and 3 acute kidney disease?
- Stage 1: 50-100% increase creatinine from baseline and < 0.5ml/kg/hour urine output for 6 hours.
- Stage 2: 100-200% increase creatinine from baseline and < 0.5ml/kg/hour urine output for 12 hours.
- Stage 3: >200% increase creatinine from baseline and < 0.3ml/kg/hour for 24 hours.
Give an example of a disease for which acute kidney disease is a risk factor.
Chronic kidney disease.
List 6 risk factors for acute kidney disease.
1 - Old age.
2 - Diabetes mellitus.
3 - Hypertension.
4 - Heart disease.
5 - Liver disease.
6 - Chronic kidney disease.
List 7 medicinal treatments for acute kidney disease.
1 - Diuretics.
2 - Angiotensin-converting enzyme inhibitors.
3 - Angiotensin receptor blockers.
4 - NSAIDs.
5 - Gentamicin.
6 - Vancomycin.
7 - Chemotherapy.
What is the cause of pre-renal acute kidney injury?
Perfusion failure.
What is the cause of post-renal acute kidney injury?
Obstruction of the urinary system.
Why might renin-angiotensin system (RAS) blockade result in pre-renal acute kidney injury?
Because RAS blockade will reduce blood volume and pressure, so renal perfusion will decrease.
List 4 causes of obstruction of the urinary system.
1 - Stones (calculi).
2 - Benign prostate.
3 - Tumours.
4 - Fibrosis.
Define hydronephrosis.
What might cause hydronephrosis?
- Swelling of the kidney.
- Caused by a blockage in the urinary system that causes urine to accumulate in the renal pelvis.
List 2 treatments for urinary obstructions.
1 - By bypassing the blockage and creating an opening between the kidney and the skin (nephrostomy).
2 - By removing the blockage with a bladder catheter.
What is meant by ‘renal’ causes of acute kidney injury?
Causes of acute kidney injury that damage the tubules, glomerulus or interstitium of the kidney.
List 8 renal causes of acute kidney injury.
Systemic diseases:
1 - Vasculitis.
2 - Systemic lupus erythematosus.
3 - Myelomas.
Infections:
4 - HIV.
5 - Endocarditis.
Allergic:
6 - Acute interstitial nephritis.
Other:
7 - Drug toxicity.
8 - Glomerulonephritis.
What are antineutrophil cytoplasmic antibodies (ANCA)?
Give an example of a condition caused by ANCA.
- Antibodies directed against antigens found in the cytoplasmic granules of neutrophils and monocytes.
- Can cause ANCA associated vasculitis.
List 2 organs that are commonly affected by ANCA associated vasculitis.
1 - Lungs.
2 - Kidneys.
What effect do ANCA have on neutrophils that cause them to be a danger to the kidneys?
The flow of neutrophils over the renal vasculature is much more turbulent, causing the neutrophils to pass through the glomerulus and release their cytotoxic granules into the kidney.
