Download MBBS Nephrology PPT 1 Acute Kidney Injury Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Nephrology PPT 1 Acute Kidney Injury Lecture Notes

Acute Kidney Injury

Definition

? Acute kidney injury (AKI) is a clinical syndrome

denoted by an abrupt decline in glomerular

filtration rate (GFR) sufficient to decrease the

elimination of nitrogenous waste products

(urea and creatinine) and other uremic toxins.


EPIDEMIOLOGY

AKI complicates 5?7% of acute care hospital

admissions and up to 30% of admissions to the

intensive care unit, particularly in the setting

of diarrheal illnesses, infectious diseases like

malaria

and

leptospirosis,

and

natural disasters such as earthquakes.


Causes

The causes of AKI are usual y divided into three broad

patho-physiologic categories:

1. Prerenal AKI--diseases characterized by effective

hypoperfusion of the kidneys in which there is no

parenchymal damage to the kidney

2. Intrinsic AKI--diseases involving the renal

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

with acute obstruction of the urinary tract


Patho-physiology

Phases of Ischemic ATN

1. Initiation Phase ? GFR declines, lasts for

hours- days

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

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

4. Recovery Phase ? gradual return of GFR

towards normal, delay in recovery of tubular

function.


Diagnosis