SAQ 314 – Renal – acute kidney injury and CRRT indications

Renal – acute kidney injury and CRRT indications.

a. AKI categories

b. ED investigations

• CT abdomen to assess the known mass and possible hydronephrosis; better than ultrasound where a mass is already known.
• VBG to assess metabolic acidosis and hyperkalaemia.
• ECG to assess for hyperkalaemic changes.
• Urinalysis for infection, haematuria, or proteinuria.

c. CRRT indications

• Potassium >6.5 mmol/L or rapidly rising potassium.
• Severe sodium disturbance, such as <100 or >160 mmol/L.
• Pulmonary oedema unresponsive to diuretics.
• Severe uncompensated metabolic acidosis, such as pH <7.1.
• Uraemic syndrome.
• Overdose with a dialysable toxin.
• Very high urea, such as >35 mmol/L.
• Creatinine >400 micromol/L.