Flashcards in Acute Kidney Injury Deck (18):
.40 year old male presenting with general malaise & haemoptysis (Urea 28, Creatinine 600, elevated ant-GBM)
25 year old IVDA found collapsed at home
82 year old man admitted with BP 70 30, T 39, pulse 140bpm, K+ 7.0, urea 48, Cr 789, CRP 250, CXR left basal consolidation
Acute tubular necrosis
80 year old male admitted with 4-5 day history of diarrhoea. On admission BP 80 40, pulse 30bpm. Bloods phone back: Na 135, K+ 8.0, Urea 50, Cr 1000, Bicarb 9
. What drug would you start first?
Give three ways that you can get pre renal acute kidney injury?
1. Hypovolaemia from d&v/burns
2. Hypotension from sepsis, cardiogenic shock or anaphylaxis
3. Reanl Hypoperfusion due to NSAIDS, ACE, ARBs on a background of poor kidney function and possible a "sick day"
Give three causes of acute tubular necrosis?
Untreated pre renal AKI
How do you treat pre renal AKI?
Fluid challenge (0.9% saline)
What is the definition of renal AKI?
Disease causing inflammation or damage to the kidney cells causing acute kidney injury.
What structures can be damaged in renal AKI?
List 6 specific caused of renal AKI?
- infection (TB)
- Ischaemia due to prolonged renal hypoperfusion
- Contrast study
What antibodies would you expect to find in SLE?
What antibodies would you expect to find in vasculitis?
What antibodies would you expect to find in goodpastures?
How would you treat renal AKI?
1. Fluid resuscitate
2. If still not at adequate BP then inotrpes or vasopressors
3. Treat underlying cause
eg antibiotics if septic
4. Stop nephrotoxic drugs
5. Dialysis if they are anuric and have uraemia.
How do you get post renal AKI?
Due to an obstruction (eg stone, stricture) obstructing the urine flow and causing hydronephrosis with reduces the concentrating ability of the kidney
How do you treat post renal AKI?
What counts as hyperkalemia?
Pottassium above 5.5