AKI - Acute Kidney Injury | Lecture Note - Edubirdie

University:
The University Of Western Ontario
Course:
Pathology 3500B | Human Pathology
Academic year:

2023
Views:

386

Pages:

3
Author:

Kyuwon J.

Acute Kidney Injury ● Sudden decline in renal function ○ over hours~days ■ decrease in glomerular filtration rates ● GFR ■ Increase in serum creatinine ■ may or may not have following decrease in uring outputs ○ typically reversible, however, in case of chronic kidney disease, it is not reversible KDIGO D checklists ● AKI is diagnosed when any of one of the following is present ○ increase in serum creatineine ■ above 0.3mg/dL in 48h ○ increase in creatinine ■ above 1.5x baseline ■ in a week ○ urine output less than 0.5ml/kg/h ■ in terms of 6h Etiology ● Pre-renal AKI ○ decrease in renal perfusions ■ pathophysiology ● reduction in effective circulating volumes ● will lead to decrease in GFR ○ structurally normal kidneys ○ Common causes ■ hypovolemia ● hemorrhage ● dehydration ● burns ■ Low cardiac outputs ● heart failures ● Cardiogenic shocks ■ Systemic vasodilation ● sepsis ● cirrhosis ■ Renal vasoconstrictions ● NSAIDs ● ACE inhibitions ○ only for susceptible patients ● Lab features ○ BUN ■ creatinine ratio of more than 20:1 ○ Urine Na+ ■ less then 20mmol/L ○ FeNA<1% ○ Concentrated urine ■ increase in osmolality Intrinsic AKI ● ATN ○ most common ○ ischemia ■ prolongation of pre-renal AKI ○ Nephrotoxins ■ aminoglycoside contrasts ■ cisplatin ■ Myoglobins ○ Urine findings ■ muddy brown casts ■ FeNa >2% ■ Urine Na+ > 40mmol/L

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