Acute kidney injury, AKI

RIFLE classification

KDIGO 2012 AKI guideline

Diagnostic criteria(required only one)

1.SCr ↑>0.3 within 48hrs

2.SCr ↑1.5 fold within 7 days

3.Urine volume< 0.5 ml/kg/hr for 6 hrs


AKI type

Prerenal

Etiology- Sepsis, hypotension, diarrhea, vomiting, hemorrhage, burn, 3rd space, renal stenosis, heart failure, cyclosporin, ACEi, NSAID, hepatorenal syndrome

Renal

1.Glomerular

Etiology- RPGN

Presentation- Edema

Lab-  Dysmorphic RBC, RBC cast

2.Tubule

Etiology- ATN→ Ischemia, nephrotoxin(NSAID, aminoglycoside, cisplatin, contrast media), myoglobinuria, hemoglobinuria, Ig light chain

3.Interstitial

Etiology- AIN→ Allergy(Sulfa drug, B lactam, NSAID, aristolochic acid), Infection(APN), infiltrative(lymphoma, sarcoid), autoimmune(Sjogren, SLE)

Triad- Fever + Rash + Eosinophilia

Lab- Eosinophilia, WBC cast

Treatment- Water restriction, K↓P↓protein↓(0.6~0.7 g/kg/day), calories(35~50 kcal/kg/day), adding sodium bicarbonate(HCO3<16 and PH<7.2)

Postrenal

Etiology- stone, stenosis, tumor, BPH, neurogenic bladder

Lab- RBC(no dysmorphic RBC)


Differentiation of Pre-renal and renal AKI



Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

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