Aki definition

Table of Contents • • • • • • Acute Kidney Injury (AKI) According to KDIGO, AKI is defined as an: 1) Increase in serum creatinine by ≥0.3 mg/dL within 48 hrs; OR, 2) Increase in serum creatinine to ≥1.5 times baseline (i.e. 50% above baseline), which is known or presumed to have occurred within the prior 7 days; OR, 3) Urine volume <0.5 mL/kg/h over a 6-hour period. Acute kidney injury is most commonly diagnosed in hospitalized patients or following a procedure. AKI develops in hours to days. Staging of AKI KDIGO stages for AKI Stage Serum Creatinine Urine output 1 1.5–1.9 times baseline (i.e. an increase of 50% to 99% from baseline) OR ≥0.3 mg/dl (≥26.5 μmol/l) increase <0.5 mL/kg/h for 6 to 12 hours 2 2.0–2.9 times baseline <0.5 mL/kg/h for 12 to 24 hours 3 3.0 times baseline OR Increase in serum creatinine to ≥4.0 mg/dl (≥353.6 μmol/l) OR Initiation of renal replacement therapy OR, In patients <18 years, decrease in eGFR to <35 ml/min per 1.73 m 2 <0.3 ml/kg/h for ≥24 hours OR Anuria for ≥12 hours Acute AKI vs. Subacute Kidney Injury vs. Chronic Kidney Disease *** The distinction between acute kidney injury (AKI), subacute injury, and chronic kidney disease (CKD) is arbitrary. However, it is still helpful. See AKI definition above and subacute and CKD below. Subacute Kidney Injury Most patients with subacute kidney injury are evaluated as outpatients. By definition, subacute kidney injury develops more slowly than AKI but generally results in an increased creatinine in ...

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Acute kidney injury is a clinical syndrome characterized by a rapid decline in glomerular filtration rate and resultant accumulation of metabolic waste products. Acute kidney injury is associated with an increased risk of mortality, cardiovascular events, and progression to chronic kidney disease. Severity of acute kidney injury is classified according to urine output and elevations in creatinine level. Etiologies of acute kidney injury are categorized as prerenal, intrinsic renal, and postrenal. Accurate diagnosis of the underlying cause is key to successful management and includes a focused history and physical examination, serum and urine electrolyte measurements, and renal ultrasonography when risk factors for a postrenal cause are present (e.g., older male with prostatic hypertrophy). General management principles for acute kidney injury include determination of volume status, fluid resuscitation with isotonic crystalloid, treatment of volume overload with diuretics, discontinuation of nephrotoxic medications, and adjustment of prescribed drugs according to renal function. Additional supportive care measures may include optimizing nutritional status and glycemic control. Pharmacist-led quality-improvement programs reduce nephrotoxic exposures and rates of acute kidney injury in the hospital setting. Acute kidney injury care bundles are associated with improved in-hospital mortality rates and reduced risk of progression. Nephrology consultation should be considered whe...

Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body. AKI can also affect other organs such as the brain, heart, and lungs. Acute kidney injury is common in patients who are in the hospital, in intensive care units, and especially in older adults. Signs and symptoms of acute kidney injury differ depending on the cause and may include: • Too little urine leaving the body • Swelling in legs, ankles, and around the eyes • Fatigue or tiredness • Shortness of breath • Confusion • Nausea • Seizures or coma in severe cases • Chest pain or pressure In some cases, AKI causes no symptoms and is only found through other tests done by your healthcare provider. Acute kidney injury can have many different causes. AKI can be caused by the following: Decreased blood flow Some diseases and conditions can slow blood flow to your kidneys and cause AKI. These diseases and conditions include: • Low blood pressure (called “hypotension”) or shock • Blood or fluid loss (such as bleeding, severe diarrhea) • Heart attack, heart failure, and other conditions leading to decreased heart function • Organ failure (e.g., heart, liver) • Overuse of pain medicines called “ • Severe allergic reactions • Burns • Injury • Major surgery Direct Damage to the Kid...