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Flashcards in Acute Kidney Injury Deck (5)
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1
Q

Types of acute renal failure

A
  • Prerenal
    Transient renal hypoperfusion due to hypotension, decreased cardiac output, decreased effective arterial blood volume
  • postrenal
    Obstruction of urinary tract
  • intrinsic
    Acute glomerulonephritis involves inflammation and damage to the glomerular membrane
    Acute interstitial nephritis, an allergic reaction, may be caused by a variety of drugs
  • acute tubular necrosis accounts for more than 50% of cases of acute renal failure- nephrotoxicagents, prolonged renal hypoperfusion
2
Q

Phase of acute renal failure

A
  • acute insult (steady rise in Cr)
  • oliguric anuric phase (UO drop to 30ml/hr, often fluid and electrolyte restrictions required
  • polyuric/ recovery phase
    Urine made but not always concentrated and can be normal or increased
    Additional fluid and electrolytes may not he required
    Monitor serum potassium and manage accordingly
3
Q

Calculating estimated requirements

A

ICU >50% mortality rate, metabolic disturbances

Ward- ~10% mortality rate, metabolic disturbances unlikely

4
Q

EN or PN

A

If oral feeding knot possible initiate enteral feeding within 24 hours
PN only indicated if GI tract not working or EN alone cannot meet requirements
(Do not overfeed >30kcal/kg/day)

5
Q

What if they are eating

A

Don’t be overly restricted unless required eg K
Monitor and change diets if RRT starts
Monitor fluid balance

Extra fluid may be given to anuric/ olgiuric patients of high fluid requirements in the polyuric phase when AKI is resolving