Acute Kidney Injury

last updated: November 23, 2016

Orlando Debesa

Pre-Renal DDx:

  • Hypovolemia

  • CHF

  • Renal Artery Stenosis

  • Sepsis

  • CIN (looks pre-renal)

Pre-Renal

  • urea increases disproportionately to creatinine due to enhanced proximal tubular reabsorption that follows the enhanced transport of sodium and water

Renal

  • renal damage causes reduced reabsorption of BUN (therefore lowering BUN/Cr ratio)

FENa

  • only useful in acute renal failure, not chronic renal failure

  • can not be used in patients on diuretics (use FEUrea)

  • consider post renal obstructive uropathy for acute renal failure regardless of FENa score (place foley or do bladder scan)

AKI, stage 1 (acute renal insufficiency) 593.9

AKI, stage 2 & 3 (acute renal injury/failure) 584.9

Classification and Role of Conventional and Novel Biomarkers

Management

  • Appropriate and Inappropriate Fluid Management of AKI

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC