AKI

Question 0

Causes of AKI

Answer 0

Pre-renal - hypo perfusion due to hypovolemia 2o to blood loss, dehydration, or volume mal distribution (sepsis, liver disease, low CV output)

Post renal - urinary tract obstruction - renal ultrasound

Renal - interstitial kidney disease, glomerularnephritis, vascular

Question 1

Definition of AKI

Answer 1

1. Reduction in urine output:
   Oliguria = urine output < 400 ml/day
   Anuria = urine output < 100 ml/day
2. Rising urea (3 - 7) and creatinine (70 to 110)

Question 2

Approach to AKI

Answer 2

Clinical assessment:

1. Hx - volume loss, history of toxins, facial edema or dark urine
2. Physical - volume status, obvious obstructive causes, systemic illness - htn, DM, purpura, rash, arthritis
   Urinary indices - UNa < 20, UOsm > 400, FeNa < 1. (U/PNa | U/Pcr)
   - blood urea/creatinine ratio

3. Urinary sediment
Hyaline casts - prerenal
Granular casts - ATN
WBC casts - interstitial nephritis
RBC casts - GN