Acute Kidney Injury
AKI = acute kidney injury is classified further into prerenal, renal, postrenal
- doesn’t account for non-oliguric states
- postrenal obstruction
- prerenal: low volume
- Na, K (and pH can easily be tested with ABG)
- Creatinine, BUN/Urea
- Cystatin C
- specific antibodies in autoimmune AKI
- Na/Urea, Creatinine
- low Na indicates prerenal cause
- Used to calculate fractional excretion of sodium or urea
- fractional excretion of sodium < 1 %: prerenal, > 2 % renal, cannot be used with diuretics
- fractional excretion of urea < 35 % prerenal, > 50 % renal, not influenced by diuretics
- improve renal perfusion
- stop nephrotoxic medications
- NSAIDs, aminoglykosides, ACE-inhibitors, AT-receptor blockers, etc.
- treat underlying causes
- furosemide does not improve renal function or revert oliguric kidney failure. Can be used to reduce volume/sodium.
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