AI Snips
Chapters
Transcript
Episode notes
AKI Definition and Approach
- Define Acute Kidney Injury (AKI) as a creatinine rise of 0.3 mg/dL or 30% from baseline within 72 hours.
- Consider AKI in three steps: urgency, context (clinical setting, comorbidities), and diagnostic approach (pre-renal, post-renal, intrinsic).
Initial AKI Workup
- Review the patient's medication list for nephrotoxic agents like antibiotics or NSAIDs.
- Check urine studies (urinalysis, microscopy, electrolytes), and consider a renal ultrasound to rule out post-renal issues.
FeNa Limitations
- Fractional excretion of sodium (FeNa) helps assess kidney sodium retention and can suggest pre-renal causes if less than 1%.
- FeNa has limitations, especially in patients with abnormal baseline renal function or on diuretics; consider urine sodium levels as a simpler alternative.