Flashcards in OnlineMedEd: Nephrology - "Acute Kidney Injury" Deck (13):
List the four categories of prerenal AKI.
• Heart failure (MI, CHF)
• Hypovolemia (diuresis, diarrhea, dehydration, hemorrhage)
• Interstitial edema (nephrotic syndrome, cirrhosis, gastrosis)
• Renal artery obstruction (renal artery stenosis, fibromuscular dysplasia)
Post-renal AKI can be caused by _______________.
any type of obstruction: urethral (prostate, stricture, stone), bladder (neurogenic, cancer) or ureteral (UVJO, URPJO, cancer, stone)
Review the three types of renal AKI.
• Acute interstitial nephritis
• Acute tubular necrosis
Review the classic triad of nephrotic syndrome.
• Proteinuria (greater than 3 g/dL/day)
Which three medicines are common causes of acute interstitial nephritis?
Look for what three lab findings in acute interstitial nephritis?
• WBC casts in urine
• WBCs in urine
• Eosinophils in urine
Acute tubular necrosis is caused by what three things?
• Toxins (contrast, myoglobin)
FENa is low (less than 1%) in which kind of AKI?
The kidneys absorb sodium when fluids are low.
Labs that suggest prerenal AKI include _________________.
BUN:Cr greater than 20, FENa less than 1%, FEUrea less than 35%, and urinary sodium less than 10
Discuss how post-renal AKI is diagnosed.
If the history and labs don't point to pre-renal AKI, then you do an US or CT to look for urinary obstruction.
Intrarenal AKI can only be definitively diagnosed with ________________.
However, if the history, physical, and UA are consistent with one diagnosis, it's reasonable to avoid the biopsy (to spare the risk).
How is post-renal AKI treated?
Catheterization, nephrostomy, or surgery to relieve the obstruction