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The Curbsiders Internal Medicine Podcast

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

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.
01:13:47

Episode guests

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Quick takeaways

  • Acute kidney injury (AKI) is primarily categorized into prerenal, intrarenal, and postrenal, affecting management strategies and clinical outcomes.
  • Fluid resuscitation using lactated Ringer's solution can effectively improve kidney function in prerenal AKI cases, emphasizing proper monitoring.

Deep dives

Understanding Acute Kidney Injury (AKI)

Acute kidney injury (AKI) is defined as a sudden decrease in kidney function, often indicated by a rise in serum creatinine or a decline in urine output. Clinically, it is categorized into three main types: prerenal, intrarenal, and postrenal. Prerenal causes are typically due to insufficient blood flow to the kidneys, which can result from factors like dehydration, shock, or heart failure. Recognizing that a majority of AKI cases are either prerenal or postrenal highlights the importance of prompt fluid resuscitation and monitoring, which can often resolve the issue.

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