Wk 3 Acute Kidney Injury

Question 1

What does acute kidney injury result from?

Answer 1

Ischemic injury

Question 2

What can cause ischemic injury?

Answer 2

Volume depletion and decreased perfusion
Toxic injury from chemicals
Sepsis

Question 3

The ischemic injury initiations what 3 responses?

Answer 3

Inflammatory
Vascular
Cell death

Question 4

What are the 3 classifications of AKI?

Answer 4

Prerenal
Intrarenal
Postrenal

Question 5

Prerenal means

Answer 5

before the kidney

Question 6

The most common cause of pre renal AKI

Answer 6

inadequate perfusion

Question 7

What are causes of inadequate perfusion? (6)

Answer 7

Hypotension
Hypovolemia
Sepsis
Decreased CO
Renal vasoconstriction
Renal artery stenosis

Question 8

What is renal artery stenosis?

Answer 8

Narrowing of one or more arteries that carry blood to your kidneys

Question 9

What else can cause inadequate perfusion to the kidneys?

Answer 9

Contrast agents that are nephrotoxic

Question 10

In pre renal AKI, the GFR is

Answer 10

decreased

Question 11

Why is the GFR decreased in pre renal AKI

Answer 11

due to low glomerular filtration pressure

Question 12

What can cause ischemic cell injury and necrosis?

Answer 12

Failure to restore BV, BP, and O2 delivery

Question 13

What is intra renal AKI?

Answer 13

Injury occurs IN the kidney

Question 14

What is the most common cause of intrarenal AKI?

Answer 14

acute tubular necrosis (ATN)

Question 15

What is acute tubular necrosis related to? (4)

Answer 15

Prerenal AKI
Nephrotoxic agents
Acute glomerulonephritis
Vascular disease

Question 16

Prerenal AKI can become…

Answer 16

Intrarenal AKI

Question 17

__ and __ cause ischemia and inflammatory response in kidney

Answer 17

Hypotension and hypovolemia

Question 18

What 4 things can cause nephrotic acute tubular necrosis?

Answer 18

Abx
Heavy metals
Contrast dye
Rhabdomyolysis

Question 19

What antibiotics can cause nephrotic acute tubular necrosis?

Answer 19

aminoglycosides

Question 20

What do you see with rhabdomyolysis?

Answer 20

Breakdown of skeletal muscle and release of excessive myoglobin

Question 21

What causes the damage to the kidneys in rhabdomyolysis?

Answer 21

The release of excess myoglobin

Question 22

What type of injury can cause rhabdomyolysis?

Answer 22

Crush injuries

Drug overdose

Question 23

What is post renal AKI?

Answer 23

Rare condition that occurs with urinary tract obstruction

Question 24

5 causes of post renal AKI

Answer 24

Bladder outlet obstruction
Prostatic hyperplasia
Bilateral ureteral obstruction
Tumor
Neurogenic bladder

Question 25

What does the obstruction cause in post renal AKI?

Answer 25

Increased renal pressure proximal to the obstruction

Question 26

How fast does AKI occur?

Answer 26

within hours

Question 27

What would the GFR be in AKI?

Answer 27

Decreased

Question 28

What is a normal GFR?

Answer 28

Greater than 90

Question 29

What is a normal urinary output?

Answer 29

Greater than 30mls/hr

Question 30

What would the urinary output be in AKI?

Answer 30

Decreased

Question 31

What would the BUN be in AKI?

Answer 31

Increased

Question 32

What is a normal BUN?

Answer 32

10-20 mg/dL

Question 33

What is a normal creatinine?

Answer 33

0.5-1.2 mg/dL

Question 34

What would be the creatinine be in AKI?

Answer 34

Increased

Question 35

AKI may be...

Answer 35

reversible

Question 36

What is creatinine?

Answer 36

Chemical compound left over from energy production in the muscles

Question 37

What is urea nitrogen?

Answer 37

Byproduct of protein breakdown

Question 38

When does oliguria occur in AKI?

Answer 38

1 day after hypotensive event

Question 39

How long does oliguria last in AKI?

Answer 39

1-3 weeks

Question 40

Oliguria is defined as...

Answer 40

Less than 400 mls/24 hrs

Question 41

What is the goal of treatment for AKI?

Answer 41

Stabilize the patient until kidney function is returned

Question 42

What is important considering electrolyte imbalances in AKI?

Answer 42

Correct fluid imbalance and hyperkalemia

Question 43

What might be prescribed to increase potassium removal for treatment of hyperkalemia?

Answer 43

furosemide (Lasix)

Question 44

What helps move potassium back into the cells temporarily? (2)

Answer 44

Insulin | Dextrose

Question 45

What are 3 potassium binders we can give to move potassium through the GI tract?

Answer 45

sodium polystyrene sulfonate patiromer sodium zirconium cyclosilicate

Question 46

A patient with AKI will have what acid-base imbalance?

Answer 46

Metabolic acidosis

Question 47

What do we give to treat the acid-base imbalance for AKI?

Answer 47

Sodium bicarbonate

Question 48

What other 2 things to do for AKI

Answer 48

Manage BP | Avoid nephrotoxic drugs