Gagal Ginjal

Question 1

Gagal Ginjal

Answer 1

Gangguan BAK/edema + gangguan fx ginjal (Ur/Cr↑)

Acute on CKD → CKD eksaserbasi akut
Hb ↓, USG ginjal kecil + Onset <3 bulan

Question 2

Gagal Ginjal (2)

Answer 2

Akut
Kronik

Question 3

Onset Gagal Ginjal Akut

Answer 3

<3 bulan

Question 4

Sifat Gagal Ginjal Akut

Answer 4

Reversibel

Question 5

Etio Gagal Ginjal Akut (3)

Answer 5

Pre renal
Renal
Post renal

Question 6

Etio Gagal Ginjal Akut: Pre Renal

Answer 6

Aliran darah ke renal ↓
Contoh: Dehidrasi, perdarahan, CHF

Question 7

Etio Gagal Ginjal Akut: Renal

Answer 7

Gangguan organ renal
Contoh: Glomerulonefritis, acute tubular nekrosis

Question 8

Etio Gangguan Ginjal Akut: Post Renal

Answer 8

Obstruksi saluran kemih
Contoh: Batu saluran kemih, BPH

Question 9

Dx Gagal Ginjal Akut

Answer 9

Hb normal, kecuali perdarahan
Ureum ↑, creatinin ↑
USG normal

Question 10

Klasifikasi Gagal Ginjal Akut

Answer 10

Based Cr 1 mg/dL

💡 R I F L E
Utama: Cr
Alternatif: UO

💡 Oliguria <0,5 cc/kgBB/jam (<400 cc)
Anuria (<100 cc)

Risk, Injury, Failure, Loss, End Stage

Question 11

Klasifikasi Gagal Ginjal Akut: Risk

Answer 11

Cr ≥1,5x ATAU oliguria 6 jam

Question 12

Klasifikasi Gagal Ginjal Akut: Injury

Answer 12

Cr ≥2x ATAU oliguria 12 jam

Question 13

Klasifikasi Gagal Ginjal Akut: Failure

Answer 13

Cr ≥3x ATAU oliguria 24 jam ATAU anuria 12 jam

Question 14

Klasifikasi Gagal Ginjal Akut: Loss

Answer 14

≥4 mgg

Question 15

Klasifikasi Gagal Ginjal Akut: End Stage

Answer 15

End stage → ≥3 bulan = CKD

Question 16

Tx Gagal Ginjal Akut

Answer 16

Atasi penyakit yang mendasari

Question 17

Onset Gagal Ginjal Kronik

Answer 17

≥3 bulan

Question 18

Sifat Gagal Ginjal Kronik

Answer 18

Irreversible

Question 19

Etio Gagal Ginjal Kronik

Answer 19

Metabolik → HT, DM

Question 20

Dx Gagal Ginjal Kronik

Answer 20

Hb ↓
Ureum ↑, creatinin ↑
USG → ginjal mengecil/contracted kidney

Question 21

Klasifikasi Gagal Ginjal Kronik

Answer 21

Utama: GFR
Alternatif: Klinis

I, II, III, IV, V

Question 22

GGK Stadium I

Answer 22

GFR ≥90

Question 23

GGK Stadium II

Answer 23

GFR 60-89

Question 24

GGK Stadium III

Answer 24

GFR 30-59 ATAU anemia

Question 25

GGK Stadium IV

Answer 25

GFR 15-29 ATAU hiperkalemia

Question 26

GGK Stadium V

Answer 26

GFR <15 ATAU overload cairan (asites, efusi pleura)

Question 27

Tx Gagal Ginjal Kronik

Answer 27

Anemia → eritropoietin
Terapi pengganti ginjal → o/k irreversible

Question 28

Terapi Pengganti Ginjal (2)

Answer 28

HD
Transplantasi Ginjal

Question 29

Indikasi HD Cito

Answer 29

Salah satu saja
A I U E O

A sidosis metabolik
I ntoksikasi
U remic syndrome/ensefalopati uremikum
E lectrolyte imbalance
O verload

Question 30

Indikasi HD Cito: Asidosis Metabolik

Answer 30

Sesak napas, kussmaul, pH asam

Question 31

Indikasi HD Cito: Intoksikasi

Answer 31

Organofosfat, cocaine, aspirin

Question 32

Indikasi HD Cito: Uremic Syndrome/Ensefalopati Uremikum

Answer 32

Penkes, mual muntah, kejang, uremia >200 mg/dL

Question 33

Indikasi HD Cito: Electrolyte Imbalance

Answer 33

Hiperkalemia >6,5 mEq/L
EKG: T-Tall

Question 34

Indikasi HD Cito: Overload

Answer 34

Edema paru → sesak napas, ronki basal paru
Asites, efusi pleura

Question 35

Indikasi HD Suportif/HD Rutin

Answer 35

Oliguria
Anuria
Miopatik uremik → nyeri otot, kram, lemah
Disnatremia → Na >160, Na <115
Hipotermia

Question 36

Indikasi Transplantasi Ginjal

Answer 36

→ paling tepat
GGK