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Title: ACUTE KIDNEY INJURY
Description: This note gave a concise up-to-date keypoints on ACUTE KIDNEY INJURY. It is concise; yet left nothing out
Description: This note gave a concise up-to-date keypoints on ACUTE KIDNEY INJURY. It is concise; yet left nothing out
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By
IHEJI CHUKWUNONSO C (MB;BS)
Definition
Types
Causes
Clinical features
Management
◦
◦
◦
◦
◦
◦
History
Physical Examination
Investigations
Staging
Diagnosis
Treatment
Prognosis
Acute Renal Failure (ARF) is a sudden ↓ in GFR
(and tubular fxn)resulting in an ↑ in blood
concentration of urea & creatinine and
impaired fluid and electrolyte homeostasis
...
Significant morbidity and mortality can
accompany ARF
...
They also
may develop associated multiorgan disease
...
Oliguric (<1ml/kg/hr in neonates & infants,
<0
...
Despite normal urine output, electrolyte
derangement and uremia may become
significant
...
It could be:
◦ Pre-renal
◦ Renal (intrinsic)
◦ Post-renal
NB: Overlap exists and a patient may
have more than one cause for their
renal failure
...
g aminoglycocides,
NSAIDS
Bilateral pyelonephritis
Myoglobinuria / haemoglobinuria
Renal artery / vein thrombosis
Congenital
◦ BOO e
...
3 mg/dl (≥26
...
5 ml/kg/h for > 6
hours
The following urinary indices may be helpful provided no diuretic have been
given:
TEST
Pre-renal
Renal
Post-renal
Urine Osmolality
(mosmol/kg)
>400 – 500
<350
Variable
Urine/P Cr ratio
>40
<20
<20
Urine Na (mmol/L)
<20
>40
Variable
FENa
<1%
>2%
Variable
FENa = [(UNa X PCr)/(PNa X Ucr)] X 100
Pay urgent attention and treat the following
early
◦ Hyperkalaemia – K+ >6
...
However, the following general mgt principles
apply:
- Observations: Daily Wt, BP, input/output
monitoring
- Fluids mgt: - Pre-renal; fluid bolus (10mL/kg of
0
...
Otherwise, restrict to
insensible loss (400mL/m2) + urine output
...
Therefore, early identification of patients who
have ARF and early intervention are necessary
to improve the current 10% to 60% mortality
rates associated with the risk factors
Title: ACUTE KIDNEY INJURY
Description: This note gave a concise up-to-date keypoints on ACUTE KIDNEY INJURY. It is concise; yet left nothing out
Description: This note gave a concise up-to-date keypoints on ACUTE KIDNEY INJURY. It is concise; yet left nothing out