What are some symptoms of acute kidney injury?
Edema, HTN, decreased urine output
Remember, there are frequently no symptoms of noticeable symptoms
Will some one with acute kidney injury have
- Increased or decreased BUN?
- Hyper or hypokalemia?
- Hyper or hyponatremia?
Increased BUN
Hyperkalemia
Hyponatremia
What are two ways we can prevent acute kidney injury?
- Sustain renal perfusion – fluid balance, blood volume, blood pressure maintenance
- “Don’t clog the pipes” – aggressive IVF in setting of hemolysis or rhabdomyolysis
What is the most important step in managing a patient with acute kidney injury?
Searching for and identifying the cause
Meticulous management of intake is very important in managing a patient with AKI, what things should we be particularly aware of?
Water (UO + 500mL), meds, proteins, potassium, sodium, and phosphorus
What does KDIGO stand for?
Kidney disease improving global outcome
What are the two KDIGO guidlines?
Rise in creatinine greater than 0.3 mg/dL from normal
Decrease in urine output to less than 3mL/kg/hr over 6 hours
Prerenal azotemia can be due to inadequate perfusion – by what 3 mechanisms?
- Dehydration (inadequate PO intake, GI losses, diuretics)
- Cardiac or hepatic failure
- Prolonged renal ischemia