AKI

Question 1

what does AKI mean

Answer 1

rapid reduction in functions such as
waste elimination
fluid/electrolyte balance
acid-base balance

Question 2

how do we diagnosis AKI

Answer 2

serum creatinine increase by 0.3 mg/dL within 48 hours
1.5x baseline
urine output of <0.5mL/kg/hr for 6 hours

Question 3

AKI high risk populations

Answer 3

older adults
DM
HTN
PVD
liver dse
CKD

Question 4

prerenal

Answer 4

impaired infusion

Question 5

intrarenal

Answer 5

damage within kidney

Question 6

postrenal

Answer 6

obstruction

Question 7

assessment of AKI

Answer 7

urine output <30/mL/hr, dark, amber
labs: high creatinine, BUN, K, Na, phos., Mg, osmolarity (no anemia)
nephrotoxic drugs: aminoglycosides, vancomycin, NSAIDs, metformin, contrast dye
MAP: <65mmHg
FVO s/s: HTN, edema, crackles, decreased O2, confusion, increased RR, dyspnea
SG: near 1.000 or >1.030 with sediment
Imaging: CT/MRI for perfusion adequacy

Question 8

treatment for AKI

Answer 8

maintain euvolemia (MAP >65-70)
minimize nephrotoxic exposure
fluid management with diuretics or IV fluids

Question 9

nutritional management

Answer 9

restrict protein, K, Na, fluids
maintain fluid based on UO (+500mL to UO)
if severe- enteral feedings low in K, Na, Phos; high cal

Question 10

renal replacement therapy

Answer 10

for symptomatic uremia, persistent hyperkalemia, severe acidosis, FVO impeding perfusion