Acute Kidney Injury/Acute Renal Failure* incomplete Flashcards Preview

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Flashcards in Acute Kidney Injury/Acute Renal Failure* incomplete Deck (15)
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1

Definition of acute renal failure and acute kidney injury?

Impairment of renal function over an acute period (days/weeks)
- acute kidney injury represents the full spectrum of acute kidney dysfunction

2

What are the 3 types of acute renal failure?

Pre-renal
Renal
Post-renal

3

What is the general cause of pre-renal acute renal failure, and what are some examples? (1 + 2)

Reduced renal perfusion

- Shock (hypovolaemic, septic, cardiogenic)
- hepatorenal syndrome (liver failure)

4

What is the main cause of renal acute renal failure we need to know? (1)

Acute glomerulonephritis

5

What are the primary and secondary (causes of causes!) causes of renal acute renal failure? (5)

- Acute tubular necrosis (ischaemia, drugs and toxins)
- Acute glomerulonephritis
- Acute interstitial nephritis (drugs)
- Small/large vessel obstruction (renal artery/vein thrombosis, cholesterol emboli, vasculitis, haemolytic microangiopathy)
- Others (Ig light-chains in multiple myeloma, urate, pigment nephropathy from haemolysis/malaria)

6

What are the primary causes of post-renal acute renal failure? (4)

- Stones
- Tumours (pelvic, prostate, bladder)
- blood clots
- retroperitoneal fibrosis

7

Presentation of acute renal failure? (7 + 1)

Malaise
Anorexia
Nausea
Vomiting
Pruritis
Drowsiness
Convulsions
Coma (uraemia-specific)
- symptoms of the cause or complications usually dominate

8

Examination findings in acute renal failure? (2)

Oedema
Signs of the cause/complications

9

Viable investigations in acute renal failure? (6)

- Bloods
- Urinalysis
- Imaging
- ECG
- Renal biopsy

10

What basic bloods are indicated in acute renal failure? (5)

FBC
U&Es
LFTs
ESR/CRP
Ca2+

11

What more specific bloods are indicated in acute renal failure and why? (2)

CK - rhabdomyolysis
Urate - uraemia

12

Other than basic blood testing, what investigations involving blood are indicated in acute renal failure? (5)

- ABG
- Cultures
- Clotting screen (PT, APTT)
- Blood film
- Serum electrophoresis and autoantibodies

13

What urine tests are indicated in acute renal failure? (4)

Dipstick
Microscopy
Culture and sensitivity
Urine osmolality/Na+

14

What types of imaging are indicated in acute renal failure and why? (2)

CXR - monitor for fluid overload (pulmonary oedema)
Renal US - exclude an obstructive cause

15

Why use ECG on acute renal failure and what could you see? (1)

Checks for hyperkalaemia (tented T-waves)