Flashcards in Renal Deck (216)
What 3 things should a general clinical examination for AKI include?
1) Rash (vasculitis)
2) Uveitis (inflammed pigmented part of the eye)
3) Joint swelling (vasculitis)
What is the risk for hypokalaemia?
May lead to life threatening arrhythmias
What 6 things would you measure in an assessmant of core volume status?
1) Core temperature (fever-increased fluid loss)
2) Peripheral perfusion (cold and clammy - hypotension)
3) Axillae (present or absence of sweat)
4) Heart rate (tachychardia - fever, haemorrhage)
5) Blood pressure (hypotension)
6) JVP (barometer of intravascular volume)
What 2 clinical signs would indicate reno-vascular disease?
1) Audible bruits
2) Impalpable peripheral pulses
Why may you palpate the lower abdomen in an examination to assess AKI?
To see if the bladder is palpable as this would indicate obstruction and thus post renal AKI
What 3 baseline lab investigations would you send off in suspected AKI and what 2 extras would you send off if infection was suspected?
4) Urine culture (if infection is suspected)
5) Blood culture (if infection is suspected)
Name 2 viruses which can potentially cause renal disease and you would send virology lab tests for?
1) Hep B/C serology
What are the majority of cases of AKI caused by?
Intrinsic secondary to pre renal or intrinsic secondary to sepsis and hypotension
What is the treatment for intrinsic AKI secondary to sepsis/ hypotension? 3
1) Adequate volume replacement - IV fluids
2) Treatment of underlying medical condition (eg. sepsis, haemorrhage)
3) Avoidance of nephrotoxic medications
What therapy is required in lupus nephritis?
What 3 pharmacokinetic properties are altered in renal failure in the acutely ill patient and therefore drug doses need to be altered appropriately?
1) Volume of distribution
3) Protein binding
Why may pulmonary oedema occur in AKI?
Retention of fluids as kidneys not filtering them out
What 3 things may uraemia lead to?
2) Neuropathy - dysfunction of peripheral nerves
3) Encephalopathy - disease in which the function of the brain is affected
What is GFR measured in?
How many stages of CKD are there?
5 with 3 being divided into 3a and 3b
What is the GFR in stage 1 CKD and what is your kidney function like?
>90 normal kidney function but urine abnormalities and structural abnormalities point to kidney disease
What is the GFR in stage 2 CKD and what is the renal function like?
60-90 mildly reduced kidney function but urine abnormalities and structural abnormalities point to kidney disease
What is the GFR in Stage 3a CKD and what is your kidney function like?
45-59 moderately reduced kidney function
What is the GFR in Stage 3b CKD and what is your kidney function like?
30-44 moderately reduced kidney function
What is the GFR in Stage 4 kidney disease and what is your kidney function like?
15-29 severely reduced kidney function
What is the most common cause of end stage kidney disease?
Name an inherited disease which can lead to CKD?
Autosomal polycystic kidney disease
Name a 1 primary and 2 secondary glomerular diseases which can lead to CKD?
Primary - membranous nephropathy
Secondary - Diabetes and lupus nephritis
Name a vascular disease which can lead to CKD?
What can cause tubulo interstitial disease which can cause CKD?
Name 2 things that cause renal tract obstruction which can cause CKD?
Renal stone disease
What are the 10 broad categories of signs and symptoms of CKD?
1) CNS effects
3) Platelet abnormalities
4) CVS effects
5) Skin symptoms
6) Renal symptoms
7) GI symptoms
8) Endocrine glands/gonads symptoms
10) Renal osteodystophy
What are the 4 GI tract symptoms in CKD?
What are the 3 endocrine/gonadal symptoms in CKD?
3) Erectile dysfunction