Renal

Question 1

Has to be stopped in AKI as increased risk of toxicity

Answer 1

Metformin
* Lithium
* Digoxin

Question 2

What should be stopped in AKI as it may worsen renal function

Answer 2

. NSAIDs (except if aspirin at cardiac dose e.g. 75mg od)
* Aminoglycosides
* ACE inhibitors
* Angiotensin II receptor antagonists
* Diuretics

Question 3

What is usually safe to continue in AKI

Answer 3

Paracetamol
* Warfarin
* Statins
* Aspirin (at a cardioprotective dose of 75mg od)
* Clopidogrel
* Beta-blockers

Question 4

Hyperkalemia stabilisation of cardiac membrane

Answer 4

Intravenous calcium gluconate

Question 5

Short term shift in potassium from extracellular to intracellular fluid compartment

Answer 5

• Combined insulin/dextrose infusion
• Nebulised salbutamol

Question 6

Removal of potassium from the body

Answer 6

Calcium resonium (orally or enema)
* Loop diuretics
* Dialysis

Question 7

Drugs causing urinary retention

Answer 7

tricyclic antidepressants e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide

Question 8

Pre renal causes of AKI

Answer 8

Hypovolaemia (e.g. dehydration, hemorrhage, 3rd spacing)
Renal artery stenosis
Sepsis
Heart/liver failure
Diuretics
ACE inhibitors
ARBs

Question 9

Renal causes of AKI

Answer 9

Blood vessels – vasculitis
Glomerular – glomerulonephritis
Interstitial – TIN
Tubular – ATN (progression of pre-renal, rhabdomyolysis, myeloma)
IV contrast
Penicillins
NSAIDs
Sulphonamides (trimethoprim)
Aminoglycosides (gentamicin)

Question 10

Post renal causes of AKI

Answer 10

Luminal – renal stone, ureteral cancer, ureteral cancer, blocked catheter
Mural – stricture
Extra-mural – prostate cancer, BPH, cervical cancer, urinary retention, constipation
Drugs for incontinence (oxybutynin)
Anticholinergics
Opiates