Acute Kidney Injury – 11/7/17

Definition of AKI

1) Increase in Cr by greater or equal to 0.3 in 48 hours
2) Increase in Cr 1.5 x baseline within 7 days
3) UOP < 0.5 mL/kg/hr x 6 hours

Causes of elevated Cr without drop in GFR

Medications that block secretion – cimetidine, TMP, and HIV medications
Increased muscle mass

Causes of elevated BUN without drop in GFR

GIB
Albumin infusions
Steroid use
Tetracycline antibiotics

Urine sediment

Pre-renal azotemia = hyaline casts
ATN = muddy brown granular casts
AIN = sterile pyuria (+/- eosinophils)
GN = protein, dysmorphic RBCS, RBC casts

Indications for dialysis

A = acidosis
E = electrolyte abnormalities refractory to medical therapy
I = intoxicants
O = overload refractory to diuretics
U = uremia

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