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PedsCrit

Acute Kidney Injury with Dr. Archana Dhar and Dr. Molly McGetrick, Part 2

Sep 27, 2021
Dr. Archana Dhar and Dr. Molly McGetrick discuss acute kidney injury (AKI) in the pediatric critical care setting. They explore topics such as diagnosing AKI, biomarkers and risk stratification, managing AKI patients, monitoring urine output, distinguishing between intrinsic and pre-renal disease, and the use of normal saline.
17:47

Podcast summary created with Snipd AI

Quick takeaways

  • Urine output is an important early indicator of renal injury and should be closely monitored every six hours to avoid missing AKI.
  • Serum cystatin C can be a more reliable marker for renal injury compared to serum creatinine, particularly in neonatal cases, as it indicates injury earlier.

Deep dives

Key Point 1: Evaluating Acute Kidney Injury (AKI)

The podcast episode discusses the evaluation and workup of acute kidney injury (AKI), focusing on a case of a 15-year-old boy who collapsed during football practice. The medical team considers dehydration as the likely cause of AKI, along with the possibility of rhabdomyolysis and cardiac issues. The initial evaluation includes baseline electrolytes, BUN, creatinine, and urine analysis. The presence of myoglobin in the urine suggests muscle breakdown, necessitating IV fluids without K, telemetry monitoring, and accurate urine output measurement.

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