PedsCrit

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

19 snips
Sep 27, 2021
Guest
Molly McGetrick
Guest
Archana Dhar
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.
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INSIGHT

Creatinine Limitations

  • Serum creatinine is influenced by muscle mass, fluid balance, and tubular secretion.
  • Certain drugs like Bactrim can elevate creatinine without actual GFR decline.
ADVICE

Early AKI Detection

  • Don't rely solely on serum creatinine to identify AKI, as it's a late indicator.
  • Monitor urine output closely, as it's an early sign of kidney injury.
INSIGHT

Cystatin C as an AKI Marker

  • Cystatin C is a more sensitive marker for AKI, peaking earlier than creatinine.
  • However, it has limitations such as longer turnaround time, hindering efficient trending.
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