AKI

Question 1

Define AKI

Answer 1

An abrupt decline of kidney function over a couple of hours or days shown by a significant increase of serum creatinine from the baseline

Question 2

Describe the different ways of categorizing AKI

Answer 2

AKI is catagorized based on the suspected location of the AKI and of the severity based in stages depending on the level of serum creatinine or the patients urine output

Question 3

describe how the severity of AKI is catagorized

Answer 3

AKI severity is split into 3 categories with stage 1 being less serious than 3

the catagories use either the patients serum creatinine or the urine output of the patient

stage 1 has an increase of 1.5-1.9 x serum creatine from the baseline

stage 2 has an increase of 2-2.9 x serum creatinine from the baseline

stage 3 has an increase of 3x serum creatinine from the baseline

Question 4

What can also indicate a stage 1 aki

Answer 4

a 0.3mg/dl serum creatinine increase

or

<0.5ml/kg/hr urine output for 6-12 hours

Question 5

what can also indicate a stage 2 aki

Answer 5

a urine output of 0.5ml/kg/h for more than 12 hours

Question 6

what can also indicate a stage 3 aki

Answer 6

a serum creatinine increase of greater than 4mg/dl

a urine output of <0.3ml/kg/hr or anuric for more than 12 hours

Question 7

what are the 3 classifications of AKI

Answer 7

Pre renal - blood flow to the kidney is reduced i.e. decreased perfusion.

Post renal - obstruction to outflow from the kidneys.

Intrinsic - damage to the functional tissues of the kidney

Question 8

what can cause a pre renal aki

Answer 8

reduced blood pressure

hypovolaemia

dehydration

gastro-intestinal bleed

sepsis

cardiac

liver failure

Question 9

what can cause a post renal aki

Answer 9

BPH - Benign prostatic hypertrophy

prostate cancer

renal calculi

retroperitoneal fibrosis

Question 10

what can cause a intrinsic aki

Answer 10

acute interstitial nephritis

hypersensitivity reaction

Question 11

what are the risk factors of developing an aki

Answer 11

<65
Dehydration
CKD
History of urological obstructions
Chronic conditions
Sepsis

Question 12

what medications can contribute to an AKI

Answer 12

NSAIDS
ACE inhib
Diuretic
Aminoglycaside

Question 13

what is the equation of creatinine clearance

Answer 13

F(140-age) x weight / serum creatinine

1.04 f // 1.23 in male

Question 14

in what patient groups should creatinine clearance be used ONLY

Answer 14

DOACS

Nephrotoxic groups

> 75

Extreme of muscle mass

Drugs that are renally excreted

Narrow therapeutic index drugs