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10 Cards in this Set
- Front
- Back
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Acute kidney injury (AKI) aka acute renal failure (ARF)
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A sudden reduction in kidney function causeing disruptions in fluid, electrolyte, and acid-base balances; retention of nitrogenous waste products; increased serum creatinine level; and decreased glomerular filtration rate (GFR). Age is an important risk factor.
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Prerenal kidney injury
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Renal failure that occurs due to decreased renal perfusion. This is related to hemodynamics and typically occurs because of reduced circulatory volume. May be caused by NSAIDS, renal emboli, and ACEI. Causes oliguria. If the problem is corrected early there will be no long term damage. Indicated by a BUN/creatinine ratio of 20:1
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Postrenal kidney injury
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Obstruction of the normal outflow of urine from the kidneys. May result in tubular necrosis if left untreated.
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Intrarenal kidney injury
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Damage to the kidney itself. This includes pyelonephritis and glomerulonephritis. Most commonly caused by acute tubular necrosis (ATN). Sepsis is a common cause of ATN. Contrast dye and other toxic medications also harm the kidney. Tubular backleak may occur. Indicated by increased BUN/creatinine level still within the 10:1 ratio.
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Acute tubular necrosis (ATN)
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This occurs due to lack of blood flow to the tubules. A common cause of intrarenal kidney injury. Occurs in the prodromal, oliguric, and postoliguric phases. Hyperkalemia may occur.
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Prodromal phase (ATN)
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Normal urine output. BUN/creatinine begin to rise.
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Oliguric phase (ATN)
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Reduced urine output with resulting water retention, hypervolemia, and edema. Presence of tubular casts, WBCs, RBCs, and protein in the urine with a decline in electrolytes excreted. Hydrogen shifts into cells while potassium shifts out. Decreased GFR with resulting waste retention.
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Postoliguric phase (ATN)
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Polyuria with resulting reduction in electrolytes and fluid previously retained. May lead to electrolyte deficits and hypovolemia. Recovery is marked by serum creatinine levels returning to normal.
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Chronic kidney disease (CKD)
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Decreased kidney function for at least 3 months Diagnosed with urinalysis blood tests and imaging studies. Also defined as a GFR <60ml/min/1.73 m2 for at least 3 months. Decline in function is irreversible and often leads to ESRD. Common causes are diabetes and hypertension. Renal function remains normal until 75-80% of nephrons are lost. Stages 1-5, stage 3 is when diagnosis occurs. BP goal is 130/80. ACEI and AIIs are given to slow progression.
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Uremic syndrome
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Buildup of metabolic wastes in the body, particularly uric acid.
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