The Internet Book of Critical Care Podcast IBCC Episode 18 - Acute Kidney Injury
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Jan 3, 2019 The podcast covers the classification, management, and prevention of acute kidney injury (AKI). It explores the different phenotypes and causes of AKI, including prerenal, intrinsic renal failure, and postrenal. The episode discusses investigating and treating causes of renal dysfunction, discontinuing nephrotoxic drugs, and managing potassium levels. It also delves into the importance of differentiating between non-oliguric and oliguric phenotypes, the use of diuretics and dialysis, and highlights pitfalls to avoid in AKI management.
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AKI Definitions
- AKI definitions (RIFLE, AKIN, KDIGO) are based on creatinine and urine output.
- These cutoffs are somewhat arbitrary and lack strong evidence-based reasoning.
AKI and Mortality
- AKI is strongly associated with increased mortality in critical care patients.
- While not a proven causal link, it's crucial to prevent or manage AKI aggressively.
AKI Phenotypes
- Patients with isolated oliguria (low urine output, stable creatinine) often have transient kidney success, not failure.
- Non-oliguric renal failure (elevated creatinine, normal urine output) has a low dialysis risk.