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Guide to Acute Kidney Injury (AKI)

What to ask/look for: 
 - HPI, PMH, full ROS
UOP/weights - Urine ... /bladder US w/ PVR ... ATN - 45% - Pre-renal ... mostly ATN and pre-renal ... #Nephrology #Diagnosis
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Kidney Injury - AKI ... microscopy / urinary ... , HIV serology, ... Kidney #Injury #AKI ... Differential #Diagnosis #nephrology
Acute Kidney Injury (AKI) - Differential Diagnosis Framework

PRE-Renal AKI:
 • Hypovolemia
 • Congestion
 • Medications
 •
Diagnosis Framework PRE-Renal ... Shunting INTRA-Renal ... Drug-induced POST-Renal ... obstruction, Neurogenic bladder ... Differential #Diagnosis #nephrology
General approach to AKI - Checklist

Urine electrolytes & FENa - Previously, it was believed that urine
General approach to AKI ... differentiate between pre-renal ... and intrinsic renal ... @PulmCrit #AKI ... AcuteKidneyInjury #Nephrology
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
gross hematuria Bladder ... • Cystitis • Bladder ... /Ureter/Bladder ... Diagnosis #causes #urology ... #nephrology #renal
Sulfa Crystals on Urine Microscopy
Sulfa Crystal!  Drug-induced crystalluria is a cause of acute renal failure
Microscopy Sulfa ... cause of acute renal ... Especially sulfonamides are ... #Microscopy #crystalluria ... #clinical #nephrology
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... Diagnosis Framework Pre-Renal ... • Neurogenic Bladder ... Medicine @SCVMCMed #AKI ... Differential #Diagnosis #nephrology
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Kidney Injury (AKI ... require urgent nephrology ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... workup #diagnosis #nephrology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Kidney Injury AKI ... thromboembolism, renal ... cancer) • Urinary bladder ... tumors INTRINSINC RENAL ... Differential #Diagnosis #nephrology
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
and concentrated urine ... tubulointerstitial nephritis, renal ... edgarvlermamd - Nephrology ... #Differential #Microscopy ... #Diagnosis #Nephrology