hyperkalemia, metabolic acidosis, hyperphosphatemia, pulmonary/peripheral edema
What are the short-term consequences to AKI? (4)
nephron loss, fibrosis, CKD, CVD, death
What are the long-term consequences of AKI? (5)
< 500 mL/day
Oliguria =
<50 mL/day
Anuria=
reduction in urine excretion
What is the first indicator of AKI?
hypoperfusion of the renal parenchyma; with or without systemic arterial hypotension
What is the cause of Pre-Renal AKI?
Sepsis
________ is one of the leading clinical conditions associated with AKI.
prostaglandins
What is the mediator of Afferent Vasodilation?
angiotensin
What is the mediator of Efferent Vasoconstriction?
NSAIDs, diuretics
What medications are involved in Pre-Renal AKI?
COX; failure to stabilize GFR
NSAIDs inhibit _________ synthesis of vasodilatory PG; resulting in ______________.
renal vasculature damage, glomerular damage, acute tubular necrosis, acute interstitial nephritis
What are the categories of Intrinsic AKI? (4)
b
Which Intrinsic AKI is caused by emboli that block the arteries?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
d
Which Intrinsic AKI is caused by circulating immune complexes that
deposit in the glomeruli?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
c
Which is the most common type of Intrinsic AKI?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
c
Which results from renal ischemia or nephrotoxins?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
a
Which Intrinsic AKI is characterized by inflammation, edema, and
inflammatory lesions?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
infections, autoimmune diseases, medications
What are the causes of Acute Interstitial Nephritis? (3)
a
Which Intrinsic AKI is the result of an idiosyncratic delayed
hypersensitivity reaction?
a) Acute Interstitial Nephritis (AIN)
b) Renal vasculature damage
c) Acute Tubular Necrosis (ATN)
d) Glomerular damage
Antibiotics, NSAIDs, PPIs, diuretics, Psych meds
Which medication classes are implicated in Acute Interstitial Nephritis? (5)
physically impinged urethra
What is the most common cause of bladder outlet obstruction?
both; significant AKI
Obstruction above the bladder must involve ______ kidneys to cause ________.
diuretics, bactrim, ciprofloxacin, acyclovir
Which medications cause accumulations of oxalate crystals? (4)
tissue death; obstruction
Some medications can cause nephrotoxicity which causes _______ and can also lead to ______.
cisplatin, Aminoglycosides, amphotericin
Which nephrotoxic medications can cause obstruction? (3)
identify contributing meds, manage fluids, reduce risk of hyperphosphatemia/hyperkalemia
How do we manage AKI? (3)