RENAL AND ELECTROLYTE
ACUTE KIDNEY INJURY
PromptDifferentials for AKI
(Stem was postop bowel resection)
(Stem was postop bowel resection)
ResponsePre-Renal
Hypovolaemia (poor PO intake, bleeding, 3rd spaces losses, malabsorption)
High output stoma
Sepsis
Renal
Nephrotoxic drugs - Gent, lithium, NSAIDS
Rhabdo
Myeloma proteins
Post-Renal
Urinary retention
Ureter damage
Hypovolaemia (poor PO intake, bleeding, 3rd spaces losses, malabsorption)
High output stoma
Sepsis
Renal
Nephrotoxic drugs - Gent, lithium, NSAIDS
Rhabdo
Myeloma proteins
Post-Renal
Urinary retention
Ureter damage
PromptInvestigations in renal failure
ResponseVBG - degree of acidosis, lactate as surrogate for tissue hypoperfusion
ECG - ? Hyperkalaemia
Bladder scan - urinary retention
MCS - ?UTI as cause for sepsis
Urine Sodium/osmolality/creatanine - Help distinguish pre-renal vs renal vs post renal causes
FBC - Anaemiea due to volume loss or indication of chronic disease. WCC marker of infection
CXR ? fluid overload
Renal u/s ? Hydronephrosis
ECG - ? Hyperkalaemia
Bladder scan - urinary retention
MCS - ?UTI as cause for sepsis
Urine Sodium/osmolality/creatanine - Help distinguish pre-renal vs renal vs post renal causes
FBC - Anaemiea due to volume loss or indication of chronic disease. WCC marker of infection
CXR ? fluid overload
Renal u/s ? Hydronephrosis
PromptUrea:Creatinine ratio and its significance
ResponseNote you must convert Creatanine from Micromols/L to Milimols/L - Ie a creatinine of 100 = 0.1
<40:1 - suggests intrinsic renal damage
40-100:1 - suggests normal renal function or post renal cause
>100:1 pre renal cause (Urea absorption increased compared to creatanine)
<40:1 - suggests intrinsic renal damage
40-100:1 - suggests normal renal function or post renal cause
>100:1 pre renal cause (Urea absorption increased compared to creatanine)