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Acute Kidney Injury

Pratha Muthiah, MPH, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

An abrupt loss of kidney function, defined as one of the following (1): 
  • Increase in serum creatinine (SCr) of ≥0.3 mg/dL within 48 hours

  • A 50% increase in SCr within 7 days

  • Urine outp...

DIAGNOSIS

Acute Kidney Injury (AKI) is usually asymptomatic until the patient has experienced extreme loss of function. Oliguria can be present, but it is neither specific nor sensitive  (3). 

HISTORY

  • A...

TREATMENT

Fluid resuscitation is the mainstay of treatment of AKI, both in prerenal and intrinsic kidney injury. In severe cases of kidney injury, dialysis may be required, especially in cases where t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Nephrology follow-up if persistent renal impairment and/or proteinuria 

DIET

  • Total caloric intake of 20 to 30 kcal/kg/day  (1)

  • Restrict Na+ to 2 g/day (unless hypovo...

REFERENCES

1
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Onter., Suppl. 2012;2:1–138.
2
Gonsales SR...

ADDITIONAL READING

  • Coca  SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int.  2012;81(5):...

SEE ALSO

  • Glomerulonephritis, Acute; Hepatorenal Syndrome; Hyperkalemia; Prostatic Hyperplasia, Benign (BPH); Chronic Kidney Disease; Reye Syndrome; Rhabdomyolysis; Sepsis

  • Algorithm: Anuria or Oliguria

CODES

ICD10

  • N17.0 Acute kidney failure with tubular necrosis

  • N17.1 Acute kidney failure with acute cortical necrosis

  • N17.8 Other acute kidney failure

  • N17.9 Acute kidney failure, unspecified

  • N17.2 Acute kid...

CLINICAL PEARLS

  • Three categories of AKI:

    • Prerenal: decreased renal perfusion (often from hypovolemia) leading to a decrease in GFR; reversible

    • Intrarenal: intrinsic kidney damage; ATN most common due to...

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