Acute Kidney Injury Flashcards
(21 cards)
What do kidneys look like on PE with AKI?
Painful
Normal to increased size
Diagnostics with AKI
Glucosuria (w normal serum glucose)
+/- casts
+/- proteinuria
Bright kidneys on US
What are nephrotoxic causes of AKI?
NSAIDs
Aminoglycosides
ACE inhibitors
Ethylene glycol
Amphotericin B
Dogs: grapes, raisins
Cats: lillies
What are infectious causes of AKI?
Bacterial pyelonephritis
Dogs: lepto, lyme
Cats: FIP
What are non-kidney conditions that can lead to AKI?
Dehydration
Fever
Hear stroke
Shock
Sepsis
Acidosis
Hypercoagulation
What organ system dysfunction can lead to AKI?
Cardiac disease
Pancreatitis
Hypotension
What are the treatments of AKI?
Culture urine
Relieve post-renal causes
Underlying causes
Discontinue nephrotoxic drugs
Decontaminate toxins
What is mandatory for all AKI patients?
Aerobic urine culture for pyelonrphritis
What is the treatment for pyelonephritis?
IV antibiotics (flurouinolones recommended)
*Enrofloxacin (Baytril)
When can lepto be detected in blood?
PCR days 1-10
When can lepto be detected in urine?
PCR days 11-14
When can IgM and IgG be detected with lepto?
IgM after 5 days
IgG after 12d
What are the treatments for leptospirosis?
1: terminate leptospiremia with ampicillin IV or doxycycline IV or PO (not doxy PO if vomiting)
2: eliminate carrier state with doxycycline PO
What are 3 examples of nephrotoxic drugs?
NSAIDs
ACE Inhibitors
Amphotericin B
How is ethylene glycol decontaminated?
Fomepizole (dogs, higher dose in cats)
How are maintenance fluids calculated?
How are fluid deficits calculated?
How are ongoing urinary losses calculated? Polyuric, relative oliguric, oliguric, anuric?
Should ACE inhibitors be used for proteinuria in AKI cases?
No!
Nephrotoxic drug = decreases GFR in a kidney that already has decreased GFR
What drugs can be utilized for anti-nausea?
Ondansetron
Maropitant
What is the mechanism of action for omeprazole?
Proton pump inhibitor
