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Flashcards in Acute Kidney Disease Deck (23)
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1
Q

What is the definition of AKD?

A

Rapid loss of glomerular filtration & tubular function over hours to days

2
Q

In AKD, what measure of GFR will be used?

A

serum Creatinine (raised)

3
Q

Why is creatinine on its own not the best measure of GFR?

A

Late marker (great loss of kidney function before mirrored in creatinine)

4
Q

The definition of AKD states that an increase of serum creatinine by ____ within _____ hours.

A

26mmol

48 hours

5
Q

What are the different stages of AKI?

A

AKI 1-3
1: urine output <0.5 6-12 hrs
2: <0.5 >12hrs
3 <0.3 for >24 hrs or anuria (12rs)

6
Q

What are the immediately dangerous consequences of AKI?

A
Acidosis
Electrolyte imbalance
Intoxification TOXINS
Overload
Uraemia complications
7
Q

The definition of AKD states urine volume is less than _____ ml/kg/h for _____ hours.

A

0.5

6 hours

8
Q

What are some of the pre-renal causes of AKI?

A

Anything which causes hypo perfusion of kidneys:

Cardiac failure
Haemorrhage
Sepsis
Vomiting & diarrhoea

9
Q

What are some of the renal (Intrinsic) cause of AKI?

A

Anything which has caused damage to kidneys:

Glomerulonephritis
Vasculitis
Radiocontrast
Myeloma
Drugs (NSAIDs &amp; gentamicin)
10
Q

What are some of the post-renal causes of AKI?

A

Anything which obstructs urine exit

Tumours
Prostate disease
Stones

11
Q

What is the most common cause of AKI?

A

Hypoperfusion of kidney (pre-renal)

12
Q

What is myeloma?

A

Haematological malignancy where proliferation of plasma cells produces an excess Igs

13
Q

What are some of the signs & symptoms of myeloma?

A
Anaemia 
Back pain
Weight loss
Farctures
Infections 
Hypercalaemia
14
Q

What is the term used for kidney disease associated with myeloma?

A

Cast nephropathy

15
Q

What are some of the risk factors associated with AKI presentation?

A
Sepsis 
Hypotension 
Hypovolaemia 
Surgery 
Heart failure 
Diabetes mellitus
Toxins (NSAIDs &amp; genticimin, radiocontrast)
16
Q

What should be avoided if AKI is suspected?

A

Nephrotoxic agents

Dehydration

17
Q

What does the STOP acronym stand for in AKI management?

A

Sepsis
Toxins
Optimise BP
Prevent harm

18
Q

What investigations may you consider if suspecting AKI?

A
Creatinine
U&amp;Es
FBC
USS
Blood gas
Urinalysis (protein, blood)
Renal biopsy
19
Q

What allows you to assess fluid status of patient?

A

Fluid volume chart

20
Q

In AKI, what can be observed on ECG? What is this caused by?

A

Tented T waves

Hyperkalaemia - can lead to cardiac arrest

21
Q

In AKI, why can some patients die from cardiac arrest?

A

Elevated K levels results in hyerkalaemia which can cause arrhythmias

22
Q

What are some of the treatment methods for hyerpkalaemia?

A
Calcium gluconate (stabilises myocardium)
Insulin-dextrose (moves K intracellularly)

Dialysis
Diuresis

23
Q

Which drugs can reach toxic levels in AKI patients?

A
Morphine 
Digoxin
Aspirin 
Lithium 
Metformin