Disease Profiles

Question 1

Pre-Renal AKI - Risk factors and causes

Answer 1

Risk factors

• Age 75+
• CKD
• Heart failure
• Peripheral vascular disease
• Chronic liver disease
• Diabetes
• Sepsis…..

Causes

• Hypoperfusion
• Hypovolaemia
• Hypotension
• Renal artery stenosis

Question 2

AKI - presentation and complications

Answer 2

Rapid deterioration in kidney function over 48 hours

Complications

• Hyperkalaemia
• Metabolic acidosis
• Pulmonary oedema
• Encephalopathy
• Uraemic pericarditis

Question 3

AKI - investigations

Answer 3

Urinalysis and Urine microscopy

U and Es, FBC, LFTs

Clotting, Creatinine Kinase, ESR, CRP

ABG

USS

Question 4

AKI - management

Answer 4

Fluid resus

Stop nephrotoxic drugs

Monitor urine output

Treat underlying cause and manage complications

Question 5

Renal AKI - causes

Answer 5

Acute tubular necrosis due to nephrotoxins/rhabdomyolysis

SLE, HSP, infection

Vasculitides, hypertension, aortic dissection, thrombus

Question 6

Chronic Kidney Disease - risk factors

Answer 6

Diabetes and Hypertension

Cardiovascular disease

Renal stones

BPH

Recurrent UTIs

SLE

Polycystic Kidney diseases

Family history of stage 5 CKD

Question 7

CKD - presentation

Answer 7

Impaired renal function for at least 90 days with abnormal structure or function

Proteinuria

Anorexia

Vomiting

Restless legs

Fatigue

Weakness

Pruritus

Bone pain…..

Question 8

CKD - investigations

Answer 8

FBC, ESR, Us and Es, glucose

Protein:Creatinine Ratio

USS

Renal biopsy

Question 9

CKD - management

Answer 9

Stop nephrotoxic drugs

Control BP and blood glucose

ACE inhibitors/ARBs

Fluid restriction

Diet

Phosphate binders

Dialysis/transplant