Diagnostics

Question 1

DEFINITION of AKI:

Answer 1

• Rise in SERUM CREATININE from baseline of at least 0.3 mg/dL within 48h or at least 50% higher than baseline within 1 week
• Reduction in URINE OUTPUT to 0.5 mL/kg per hour for longer than 6 hours

Question 2

How to distinguish CKD from AKI?

Answer 2

RADIOLOGIC STUDY:
- small, shrunken kidneys with cortical thinning on renal ultrasound or evidence of renal osteodystrophy

-SHRUNKEN, CORTICAL THINNING, OSTEODYSTROPHY

LABORATORY TESTS:

• Normocytic anemia in the absence of blood loss or
• Secondary hyperparathyroidism, hyperphosohatemia, and hypocalcemia

Question 3

Are there tests to determine AKI SUPERIMPOSED on CKD?

Answer 3

None

Question 4

Why is there secondary hyperparathyroidism, hyperphosphatemia, and hypocalcemia in AKI?

Answer 4

secondary hyperparathyroidism
-due to compensation of the parathyroid gland in response to low serum calcium sec. to decreased absorption in the gut, decreased release from the bones, and reduced reabsorption in the diseased kidneys

hyperphosphatemia:
-due to decreased excretion in the kidneys and to increased production by the compensating parathyroid gland

hypocalcemia:
-due to decreased absorption in the gut (following decreased uptake of active vit. d in the diseased kidneys),
-decreased reabsorption in the kidneys
-decreased released from the bone
decreased release from the bones, and reduced reabsorption in the diseased kidneys