The Curbsiders Internal Medicine Podcast

REBOOT #226 Kidney Boy on Acute Kidney Injury: Myths & Musings

13 snips
Aug 12, 2024
Join Dr. Joel Topf, Chief of Nephrology, as he dives into the intricate world of acute kidney injury (AKI). With humor and expertise, he demystifies common myths around nephrotoxicity, including risks tied to vancomycin and NSAIDs. Learn about the critical factors in diagnosing and managing AKI, particularly in high-risk patients. From understanding urine output to navigating the challenges of acute interstitial nephritis, Dr. Topf shares valuable tips for both clinicians and curious minds alike.
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ADVICE

AKI Schema

  • Categorize AKI as prerenal, postrenal, or intrarenal.
  • Most AKI cases (70-90%) are prerenal or postrenal, often resolved with fluids and a Foley catheter.
INSIGHT

AKI Biomarkers

  • Urine output and creatinine remain the most practical markers for AKI.
  • New biomarkers are perpetually "five years away" and not yet clinically useful.
ADVICE

Initial AKI Management

  • After diagnosing AKI, determine urine output (oliguric, anuric, non-oliguric).
  • Establish etiology and address life-threatening electrolyte abnormalities.
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