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Acute Kidney Injury (AKI) in Patients with Cancer 

Cancer Related 
• Hypercalcemia 
• Intravenous contrast 
•
Kidney Injury (AKI ... gammopathy of renal ... Hepatic sinusoidal obstructive ... bladder outlet obstruction ... Differential #Diagnosis #Classification
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Differential Diagnosis Algorithm ... at least 50% Renal ... Pigments Tubular Obstruction ... (Obstruction/hydronephrosis
Guide to Acute Kidney Injury (AKI)

What to ask/look for: 
 - HPI, PMH, full ROS
protein/Cr - Renal ... rhabdo/TLS) Causes ... Urinary tract obstruction ... Nephrology #Diagnosis #Algorithm ... #Causes #Differential
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... : • Obstruction ... Medicine @SCVMCMed #AKI ... Diagnosis #nephrology #causes ... #algorithm
Acute Kidney Injury (AKI) - Differential Diagnosis Framework

PRE-Renal AKI:
 • Hypovolemia
 • Congestion
 • Medications
 •
Framework PRE-Renal ... Shunting INTRA-Renal ... Drug-induced POST-Renal ... Retention: Internal obstruction ... , External obstruction
Hypotension / Shock Differential Diagnosis Algorithm
Hypovolemic:
 • Poor oral intake
 • Hemorrhage
 • Renal loss
 •
Differential Diagnosis Algorithm ... Hemorrhage • Renal ... ventricular outflow obstruction ... Dysautonomia Obstructive ... #shock #causes
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
Kidney Injury - Classification ... tubular necrosis (causes ... prolonged prerenal AKI ... Postrenal: • Ureteral obstruction ... requires bilateral obstruction
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Workup Algorithm ... osmolarity If cause ... hypovolaemia and obstruction ... #Workup #Algorithm ... Diagnosis #nephrology #causes
Acute Kidney Injury - Differential Diagnosis Framework
PRERENAL:
 - Intrarenal vasoconstriction-hemodynamically mediated
 - Systemic vasodilation
 - Volume
- Diaqnosis: Renal ... treating underlying cause ... POSTRENAL: - Obstruction ... Manaqement: Relief of obstruction ... Kidney #Injury #AKI
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Kidney Injury (AKI ... volume, Urinary obstruction ... PROBLEM ~80% of AKI ... azotemia or postrenal obstruction ... to assess for obstruction