Flashcards in Acute Kidney Injury Deck (34)
Kidney receives ______% of the CO
Acute Kidney Injury is defined as an abrupt (within ____ hours) reduction in kidney function, an absolute increased in serum creatinine greater than or equal to ____ mg/dl, an increase in serum creatinine greater than or equal to ____ from baseline, or a reduction in urine output less than or equal to ____ ml/kg per hour for more than 6 hours.
48 hours; 0.3 mg/dl; 50%; 0.5 ml/kg
This is an important determinant of long-term survival after Cardiovascular Surgery
Acute Kidney Injury
Research suggests that even after complete recovery of renal function after a CV surgery, patient survival rate was the same as not having AKI after the surgery.
False, Even with complete renal function recovery, patient survival rate was still lower.
Normal Value for Na+ on the Basic Metabolic Profile
Normal Value for Cl- on the Basic Metabolic Profile
Normal Value for BUN on the Basic Metabolic Profile
Normal Value for Bicarb on the Basic Metabolic Profile
Normal Value for K+ on the Basic Metabolic Profile
Normal Value for Creatinine on the Basic Metabolic Profile
Normal Value for Glucose on the Basic Metabolic Profile
This type of AKI is defined as a sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury.
This type of AKI is defined as a sudden and severe drop in blood pressure (shock) or interruption of blood flow to the kidneys from severe injury or illness.
This type of AKI is defined as a direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply.
What is important to ask in a history when suspecting AKI?
1. Volume Loss
4. Radiocontrast Use
5. GI Bleeding
What Imaging Studies would you use to check for suspected AKI?
What lab studies will you use to check for suspected AKI?
1. Biochemical Tests (BUN/Creat)
2. Urinalysis (Electrolyres, Eosinophils)
What interventions can be used in a patient with AKI?
1. Fluid challenge
2. Foley catheter
DDx for Prerenal Azotemia
1. Etiology: Poor renal perfusion
2. Serum BUN:Cr Ratio : > 20:1
3. U(Na): 500
6. Urinary Sediment: Benign or hyaline casts
Fractional Excretion of Na+
(Urine (Na) / Plasma (Na)) / (Urine (Cr) / Plasma (Cr)) x 100%
In pre-renal AKI, what are common characteristics that you will see in relation to the nephron?
1. Decreased Blood Flow
2. Decreased Excretion of Na and water
3. Tubules conserve Na and water
About how long does a hospitalization need to be to treat elevated BUN/Creatinine in a person with prerenal AKI (to return it back to normal)
About 7 days
What does BUN stand for?
Blood urea nitrogen
What does BUN test for?
Measures the amount of nitrogen in your blood that comes from the waste product urea.
Where is urea made and what are the precursors?
Made in the liver and passed our through urine. Precursors are proteins in the body.
What can cause an increased production of BUN?
1. Amino Acid Infusion (TPN)
2. Increased protein intake
5. GI Bleeding
What does TPN stand for?
Total Paraenteral Nutrition
How much of the urine excreted is urea?
Creatinine Levels can change dependent on what factors?
1. Sex (Men higher than women)
2. Age (Decreases as you age)