Acute kidney injury Flashcards
(40 cards)
The NICE criteria measure …. to assess for AKI
Serum creatinine
An increase by how much micromol/L of creatinine in 48 hrs signifies an AKI
> 25
An increase in what % of serum creatinine over 7 days signifies an AKI
50
A decrease of urine output by how much for 6 hours signifies an AKI
<0.5 ml/kg/hour
Nephrotoxic meds & substances that are RFs of AKI
- NSAIDs
- ACEi
- contrast medium use
Other AKI RFs (just to be aware of)
- CKD
- HF
- DM
- liver disease
- surgery
- > 65yo
- cognitive impairment
Most common cause of AKI
Pre-renal
Underlying pathology in pre-renal AKI
Inadequate renal perfusion
Pre-renal & renal AKI lead to
Reduced blood filtration
Causes of pre-renal AKI
- dehydration
- hypotension
- HF
Underlying pathology of renal AKI
Intrinsic kidney disease
Causes of renal AKI
- glomerulonephrtis
- interstitial nephritis
- acute tubular necrosis
Underlying pathology of post-renal kidney disease
Obstruction of outflow
Post-renal kidney disease leads to & how does that lead to reduced kidney function
Obstructive uropathy —> back-pressure
Causes of post-renal AKI
- kidney stones
- masses
- urethral strictures
- enlarged prostate
In a urinalysis, interpret the presence of: leukocytes + nitrates; protein + blood; glucose
- infection
- acute nephritis
- diabetes
USS can be used to exclude
Obstruction
Prevention of AKI
- hydration
- cease nephrotoxic meds
Philosophy of AKI Tx
Treat underlying cause
When to use IV fluid rehydration
Pre-renal
Restoring perfusion and filtration pressure is done thru
Ceasing nephrotoxic medications
Post-renal AKI is resolved by
Removing obstruction
Severe/doubtful cases solutions (2)
- specialist
- dialysis
AKI complications (list to be aware of)
- hyperK —> peripheral neuropathy
- fluid overload —> HF, p oedema
- metabolic acidosis —> ++H+
- encephalopathy/pericarditis —> uraemia
