AKI Flashcards
(41 cards)
What should indicate dialysis or haemofilitraito in AKI?
AEIOU
A= acidosis metabolic with pH of less than 7.2
E= electrolyte imbalance of resistant hyperkalemia
I= intoxication with drugs or poisoning
O=oedema that is refractory
U= uraemic encephalopathy or perciarditis
What are the investigations at bedside for AKI?
Urinalysis with urine did
ECG for hyperkalemia complications
Blood gas for acidosis
What are the investigations for AKI?
U&Es for Creatine a dn hyperkalemia
FBC for:
anaemia indicating vasculitis
Raised wBC in infection
Bone profile for hypercalcaemia
Creatine kinase for rhabdomyolysis
What imaging is performed for AKI?
Bladder scan for urinary retention suspected
Ultrasound of kindeys, ureters and bladder
CT KUB is more sensitive
What is the management of AKI?
IV fluid resuscitation
Catheter for post-renal AKI
Manage electrolyte complications
Suspend Nephrotoxic drugs like NSAIDs An aminoglycosides
What is the indication for dialysis?
AEIOU
A= acidosis of 7.2 or less
E=electrolyte K+ high and unresponsive
I= intoxication
O= oedema refractory and pulmoanry oedema
U= uraemic complications of pericarditis, encephalopathy and seizures
What investigation for post-rena acute AKI?
Bladder scan
Flushing urinary catheter
Which type of damage does rhabdomyolysis cause?
Acute tubular necrosis
Which drug should be withheld in AKI with hypotension?
Antihypertensives like ACE inhibitors
Loop diuretic
Which drug should be withheld in AKI because of risk of lactic acidosis?
Metformin
What is the best course of management for renal colic main?
Urgent decompression with nephrostomy, that drains the urine from the kidney through an opening in the bac
What is the indication for renal nephrostomy?
Draining the bladder of urine based on the SIRS criteria for systemic inflammatory response syndrome being:
High body temp
High heart rate
High resp rate
Partial pressure of CO2 low
What is the risk factors including being for AKI?
Post-obstructive diuresis
How does reperfusion injury in acute limb ischaemia cause AKI?
Tissue damage causes release of myoglobin, causing acute tubular necrosis
How does trimethoprim affect kidney?
Trimethoprim with inhibits tubular creatinine secretion with NO effect on urea, causing AKI
How does nitrofurantoin affect kidney?
Primary eliminated in the kidneys, and should be avoided where there is ow GFR in AKI and CKD or there will be reduced efficacy
What is the threshold to withhold Metformin?
Reduce dose for eGFR less than 45
EGFR less 30
What is a risk after a prolonged ischaemic event?
Acute tubular necrosis
-> other causes include sepsis, nephrotoixn, contrast and rhabdomyolysis
What is the cause of tuberointerstitial nephritis?
Presents with fever, rash and eosinophilia
-> causes include drugs and infections
How is diagnosis of AKI made?
Rise in creatinine by 1.5x or absolute increase more than 26.4
Urine output less than 0.5ml/kg
How is AKI staged?
Based on criteria of either creatinine or urine output
What is stage 1 AKI?
Rise in Creatine more than 1.5-1.9x baseline
OR
Increase in creatinine by 26.5
OR
Urine output less than 0.5ml/kg/hour for 6 hours
Stage 2 AKI?
Rise in creatinine between 2 to 2.9x OR
Urine output less than 0.5 for 12 hours or more
