AKI and CKD Flashcards

1
Q

Define AKI

A

A significant deterioration in renal function, which is potentially reversible, over a period of hours or days

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2
Q

Name the three different causes of AKI

A

1) Pre-renal failure
2) Intrinsic renal failure
3) Post-renal failure

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3
Q

What are the causes of pre-renal failure AKI?

A

Renal hypoperfusion

Can be systemic eg. hypovolaemia (bleeding, dehydration) or sepsis

Can be local eg. renal artery stenosis or drugs (ACE inhibitors, NSAIDs)

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4
Q

What are the causes of intrinsic renal failure?

A

Primary renal disease
- Glomerulonephritis

Secondary renal disease
- Diabetes, SLE, myeloma, etc.

Interstitial nephritis
- Usually caused by drugs

Secondary ATN (Acute tubular necrosis – temporary)
- Established after pre-renal failure
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5
Q

What causes post-renal failure?

A

Obstruction/blockage of drainage from kidneys.

Is it a stone in the lumen? Or a tumour in the wall or from somewhere else compressing?

Blockage after the bladder is urinary retention – need a catheter. Can diagnose with abdominal exam – palpate bladder.
Blockage before bladder is hydronephrosis – there is a back pressure, swelling of ureters and kidneys. Can only diagnose with ultrasound.

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6
Q

What are the tests for renal dysfunction?

A

Blood tests, urine tests, radiological tests

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7
Q

How is AKI different from CKD?

A

AKI lasts for hours/days and is reversible

CKD lasts for months/years and is irreversible

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8
Q

What are some complications of CKD?

A

Cardiovascular disease, hypertension, anaemia, bone-mineral metabolism, poor nutritional and functional status, progression of CKD, AKI

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9
Q

How do you measure CKD?

A

Tests for renal excretory function eg. creatinine, cystatin C, eGFR

Tests for albuminuria (proteinuria)

Tests for complications

Diagnostic blood tests

Radiological tests

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10
Q

What risk factors are associated with CKD progression?

A
Hypertension
Diabetes mellitus
Albuminuria
Cardiovascular disease
Smoking
Ethnicity
NSAIDs
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11
Q

What is Established Renal Failure?

A

Also known as ESRF, ESRD, ESKD

The stage of CKD where renal replacement therapy (RRT) is required to safely sustain life

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12
Q

Give four examples of renal replacement therapy

A

1) Haemodialysis (hospital, satellite, home)
2) Peritoneal Dialysis (CAPD, APD)

3) Transplantation
	Deceased-donor transplant
	Living-donor transplant (including pre-emptive)
	Other options (e.g. kidney-pancreas, paired-exchange, desensitisation)

4) Conservative care

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