AKI

Question 1

what is this?

Answer 1

acute drop in kidney function, diagnosed by measuring Creatinine

Accoring to NICE guidelines:

• rise in creatinine >25micromol/L in 48h
• rise in creatinine by >50% in last 7 days
• urine output of <0.5ml/kg/hour for more than 6 hrs

Question 2

risk factors?

Answer 2

• HF
• CKD
• Liver disease- hepatorenal syndrome
• diabetes
• older age
• nephrotoxic drugs ie NSAIDs and ACEI
• contrast medium

Question 3

Causes

Answer 3

• Pre-renal
  
  • hypovolaemia
  • dehydration
  • HF
• Renal- reduced filtration of blood
  
  • GN
  • interstitial nephritis
  • acute tubular necrosis
  • rhabdomyolysis
  • drugs (NSAIDs, gentamicin)
  • radiocontrast
  • myeloma
• Post-renal
  
  • kidney stones
  • ureteric/ urethral stricture
  • mass
  • prostate enlargment or cancer

Question 4

Ix

Answer 4

• urinalysis
  
  • protein, blood, glucose, leucocytes & nitrites
• renal tract USS - for obstruction

Question 5

Mx

Answer 5

prevention V IMPORTANT :

• adequate fluid input
• avoid nephrotoxic drugs

Mx= IV fluid rehydration, stop nephrotoxic drugs & relieve obstruction if there is any

Question 6

complications?

Answer 6

• uraemia
• metabolic acidosis
• hyperkalaemia
• fluid overload