becoming a better Clinician
Acute Kidney Injury
last updated: November 23, 2016
Orlando Debesa
Pre-Renal DDx:
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Hypovolemia
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CHF
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Renal Artery Stenosis
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Sepsis
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CIN (looks pre-renal)
Pre-Renal
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urea increases disproportionately to creatinine due to enhanced proximal tubular reabsorption that follows the enhanced transport of sodium and water
Renal
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renal damage causes reduced reabsorption of BUN (therefore lowering BUN/Cr ratio)
FENa
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only useful in acute renal failure, not chronic renal failure
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can not be used in patients on diuretics (use FEUrea)
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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
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Appropriate and Inappropriate Fluid Management of AKI