Download MBBS Nephrology PPT 1 Acute Kidney Injury Lecture Notes

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? Acute kidney injury (AKI) is a clinical syndrome

denoted by an abrupt decline in glomerular

filtration rate (GFR) sufficient to decrease the

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elimination of nitrogenous waste products

(urea and creatinine) and other uremic toxins.

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EPIDEMIOLOGY

AKI complicates 5?7% of acute care hospital

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admissions and up to 30% of admissions to the

intensive care unit, particularly in the setting

of diarrheal illnesses, infectious diseases like

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malaria

and

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leptospirosis,

and

natural disasters such as earthquakes.

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Causes

The causes of AKI are usual y divided into three broad

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patho-physiologic categories:

1. Prerenal AKI--diseases characterized by effective

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hypoperfusion of the kidneys in which there is no

parenchymal damage to the kidney

2. Intrinsic AKI--diseases involving the renal

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parenchyma
3. Postrenal (obstructive) AKI--diseases associated

with acute obstruction of the urinary tract

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Patho-physiology

Phases of Ischemic ATN

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1. Initiation Phase ? GFR declines, lasts for

hours- days

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2. Extension Phase ? continued damage
3. Maintenance Phase ? GFR stabilises at nadir

of 5-10 ml/min, lasts for 1-2 wks

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4. Recovery Phase ? gradual return of GFR

towards normal, delay in recovery of tubular

function.

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Diagnosis

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