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Index
»
MANUFACTURE FINALS
»
ACUTE RENAL FAILURE
»
Level 2
level: Level 2
Questions and Answers List
level questions: Level 2
Question
Answer
RISK FACTORS of AKI / ARF
Advance age Blockages of the blood vessel Diabetes High blood pressure Heart failure Kidney disease Liver disease
Symptoms of ARF/ AKI
Too little urine Nocturnal urination Shortness of breath Vomiting / Diarrhea Nausea, fatigue, tired / weakness Seizures / coma Chestpain Low blood pressure
Diagnostics FOR ARF/ AKI
1 Urine tests 2 Blood tests 3 Imaging tests. 4 Kidney biopsy
NON PCOL THERAPIES
1.Hydration 2. Renal replacement therapies (RRTs)
prevent contrast induced nephrotoxicity (CIN) ex: Sodium bicarbonate (tx for acidosis) , Normal saline infusion
Hydration
extracorporeal blood purification” such as hemodialysis and peritoneal dialysis. Manage uremia, metabolic acidosis, hyperkalemia, and complications of excess fluid retention, such as pulmonary edema and accumulation of renally cleared medications Disadv: Expensive
Renal replacement therapies (RRTs)
PCOL THERAPIES
1. Ascorbic acid 2. N--acetylcysteine 3. Potassium lowering drugs 4. Phosphorous lowering drugs 5 Diuretics: Furosemide and mannitol 6 Dopamine Agonist: Fenoldepam
its antioxidant properties are thought to alleviate oxidative stress caused by CIN-associated ischemia reperfusion injury Adv: Has excellent safety profile and low cost
Ascorbic acid
as antioxidant ppt. which prevents (contrast induced nephrotoxicity) CIN in patients with renal insufficiency.
N--acetylcysteine
1 Calcium gluconate, Insulin and glucose 2 Calcium carbonate (Alka-Seltzer or Tums)
1 Potassium lowering drugs 2 Phosphorous lowering drugs
Adv: Reduces fluid overload, increase urine output Disadv: Ototoxicity, increase mortality/ non- recovery of renal function. (esp. mannitol must be monitored). not recommended but has purpose.
Diuretics: Furosemide and mannitol
A non-selective DRA which used to dilate the renal arteries through stimulation of dopaminergic receptors. Adv: Low dose of dopamine increases renal blood flow Disadv: Ineffective in prevention of AKI. not recommended but has purpose.
Dopamine Agonist: Fenoldepam