Definition

A deterioration of renal function over days - weeks

• Damage often reversible

Meeting one of 3 criteria:

1. 50% increase of sCr (60-100 umol/L) in 7 days (from baseline)
2. 26.5 umol of sCr (60-100 umol/L) in 48 hours (2 days) → Not ideal
3. Oliguria: UV < 0.5 ml/kg/hour → helpful if patient is catheterized

Stage 3 AKI:

• Anuric
• sCr 3 x of BL

Complications

1. Volume overload (impaired Na excretion)
2. !Hyperkalemia - ↑K (> 5) (impaired Na excretion)
3. Metabolic Acidosis (impaired H excretion)
4. Uremia (impaired urea excretion)

Etiologies

Untitled

• Normal Table (save for a few days just in case)

Diagnosis Approach

<aside>

1. AKI? Toxins?
2. Patient Stable?
3. Post-renal → Urology/IR
   1. Foley
   2. Nephrostomy tube
   3. Urinary retention
   4. BPH
4. Dialysis needed?
   • Refractory AEIOU
5. Pre-renal AKI ?
   1. !Hypovolemia ↓
   2. Extravascular overload, Distributive shock
6. Renal?
   1. ATN - Acute tubular necrosis
   2. AIN - Acute Interstitial nephritis
   3. Nephrotic syndrome (>3.5)
   4. Nephritic syndrome </aside>

Hx

• Baseline? CKD? Relevant diseases? (Cancer, lupus, etc)
• Detailed medication history