The Clinical Problem Solvers Episode 21 – Intrarenal Acute Kidney Injury with Dr. Restrepo
Mar 21, 2019
Dr. Daniel Restrepo, Chief Resident at Massachusetts General Hospital and an aficionado of medical education, shares valuable insights on intrarenal acute kidney injury (AKI). He discusses a compelling case study of a hiker with AKI, detailing her symptoms and the diagnostic approach. The conversation dives into differentiating AKI from chronic kidney issues, highlighting complex diagnostics and the significance of thorough history-taking. Restrepo also challenges conventional diagnostic norms, emphasizing critical thinking in clinical settings.
AI Snips
Chapters
Transcript
Episode notes
Differentiating AKI from CKD
- Check prior creatinine levels or renal ultrasound to differentiate AKI from chronic kidney disease.
- Consider parathyroid hormone levels for chronic kidney disease indications like secondary hyperparathyroidism.
Prioritize Pre- and Post-Renal AKI
- Most AKI cases are due to hemodynamic (pre-renal) or obstructive (post-renal) causes.
- Prioritize assessing pre- and post-renal causes first using clinical clues and simple tests.
Manage Nephrotoxic Medications
- Always review and hold nephrotoxic medications when evaluating a patient with AKI.
- Adjust medication dosing as kidney function improves to prevent further injury.
