Salty Situations
The most life-threatening electrolyte abnormality associated with AKI.
What is hyperkalemia?
Fluid overload in AKI may cause this respiratory sign, often heard on auscultation.
What are crackles/pulmonary edema?
This test should be performed in most cases of AKI, especially if pyuria, bacteriuria, leukocytosis, or fever are present.
What is a urine culture?
This electrolyte abnormality, common in AKI, can lead to bradyarrhythmias, ventricular fibrillation, or cardiac arrest if not promptly managed.
What is hyperkalemia?
Proteinuria with normal urine specific gravity points toward this part of the nephron being affected.
What is the glomerulus?
This type of sodium abnormality may result from severe polyuria during the recovery phase of AKI.
What is hypernatremia?
Name two objective parameters used to monitor fluid status in AKI patients.
What are body weight and CRT? (Also accepted: heart rate, pulse quality, temperature pf extremities, and mentation)
Isosthenuria is defined as a USG range of:
What is 1.008 to 1.012?
The presence of abundant calcium oxalate monohydrate crystals in urine along with high anion gap metabolic acidosis and hypocalcemia suggests this toxicosis.
What is ethylene glycol poisoning?
Name two common historical clinical signs of AKI.
What are vomiting and anorexia?
Other answers: pu/pd, diarrhea, listlessness
This should be monitored closely in AKI patients to prevent worsening sodium imbalance.
What is fluid input and output (fluid balance) and Na concentration?
List 2 indications for hemodialysis for a patient diagnosed with AKI.
Anuria or oliguria, severe uremia, severe fluid overload
Renal azotemia is usually diagnosed when this percent or more of nephrons are nonfunctional.
What is 75%?
Name two nephrotoxic drugs whose use should be avoided or dose-adjusted in patients with underlying kidney dysfunction, and explain why.
What are aminoglycosides and NSAIDs; aminoglycosides cause direct tubular damage, while NSAIDs reduce renal perfusion via prostaglandin inhibition.
The most common cause of prerenal AKI is this condition, often due to dehydration or blood loss.
What is hypovolemia?
Correcting hyponatremia too quickly can cause this catastrophic neurologic syndrome.
What is osmotic demyelination syndrome?
Also called central pontine myelinolysis
In a dehydrated hypernatremic patient, free water replacement is best accomplished with this type of fluid.
What are fluids that contain free water/hypotonic solutions?
Ex: D5W
This urine finding can indicate active tubular damage in renal AKI.
What are granular casts?
This cardiovascular complication can occur in AKI due to fluid overload or activation of the renin-angiotensin-aldosterone system, and may be severe enough to cause retinal hemorrhage or detachment.
What is systemic hypertension?
Severe azotemia can cause this odor on the patient’s breath.
What is uremic breath or ammonia-like odor?
Explain why hypernatremia may develop during the recovery phase of AKI and how you would adjust fluid therapy accordingly.
What is solute (Na⁺) retention plus free water loss due to impaired concentrating ability and polyuria; adjust fluids by increasing free water (e.g., lower sodium content crystalloids or D5W supplementation) to match high urine output and prevent dehydration.
You suspect a hospitalized AKI patient is oliguric. Name one method to quantify urine output in mL/kg/hr and one major limitation of this method.
What is a closed urinary catheter collection system; limitation = risk of UTI or misinterpretation due to leakage/kinking.
This diagnostic procedure is preferred over IV pyelography when a ureteral obstruction is suspected in an AKI patient with low GFR, because it does not depend on contrast excretion through the kidneys.
What is antegrade pyelography?
Describe two ultrasonographic findings that suggest acute kidney injury.
What are hyperechoic renal cortices and perirenal free fluid (AKI)?
A dog with increasing creatinine from 1.3 → 1.9 mg/dL over 48 hours and urine output of 0.4 mL/kg/hr fits into this IRIS AKI stage and substaging.
What is IRIS AKI Stage II, oliguric?