Nephrotoxins Flashcards
1
Q
Name some drugs which are nephrotoxic.
A
- ACEi/ARBs
- NSAIDs
- Aminoglycosides e.g. gentamicin
- Contrast
2
Q
What eGFR is the cut-off for contrast?
A
eGFR of < 30 mL/min/1.73m2
3
Q
What is rhabdomyolysis?
A
Skeletal muscle breakdown, releasing breakdown products into the blood such as myoglobin, potassium, phosphate and creatine kinase.
4
Q
Which breakdown product in rhabdomyolysis is particularly nephrotoxic?
A
Myoglobin
5
Q
What causes rhabdomyolysis?
A
- Long lie (prolonged immobility)
- Rigorous exercise
- Crush injuries
- Seizures
6
Q
What are the signs and symptoms of rhabdomyolysis?
A
- Brown-red urine (myoglobinuria)
- Oedema
- Fatigue
- Confusion
- Myalgia
7
Q
What bloods would you do in rhabdomyolysis?
A
- Creatine kinase (raised for 1-3 days)
- UsEs (hyperkalaemia, eGFR)
8
Q
What will a urine dip show in rhabdomyolysis?
A
Myoglobinuria
9
Q
How is rhabdomyolysis treated?
A
- IV fluids as mainstay
- IV sodium bicarbonate for the metabolic acidosis
- IV mannitol to increase GFR and excrete products
10
Q
Why is an ECG important in rhabdomyolysis and what might you see?
A
Rhabdom. can cause hyperkalaemia
- tall T
- flat P
- broad QRS
