User:Mr. Ibrahem/Acute kidney injury
| Acute kidney injury | |
|---|---|
| Other names | Acute renal failure (ARF)[1] |
 | |
| Kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue in a person with acute kidney injury. | |
| Specialty | Nephrology, urology |
| Types | Prerenal, intrinsic kidney, post-renal[2] |
| Causes | Prerenal: Bleeding, vomiting, diarrhea, sepsis, NSAIDs[2] Intrinsic: acute tubular necrosis, interstitial nephritis, glomerulonephritis[2] Post-renal: kidney stones, bladder cancer, urinary obstruction[2] |
| Diagnostic method | 50% increase serum creatinine in 7 days, 26.5 umol/L (0.3 mg/dL) increase in 2 days, urine output < 0.5 mL/kg per hour x 6hrs[2] |
| Treatment | Prerenal: Intravenous fluids[2] Intrinsic: Supportive care, furosemide, immunosuppressants[2] Post-renal: Urinary tract drainage[2] |
| Prognosis | Often reversible[2] |
| Frequency | Common[2] |
Acute kidney injury (AKI), previously called acute renal failure (ARF), is the sudden decrease in kidney function.[2] Symptoms may include a decrease in urine output.[2] Complications may include pulmonary edema, uremia, and electrolyte abnormalities such as high blood potassium and metabolic acidosis.[2]
Causes can be divided into prerenal, intrinsic kidney, and post-renal.[2] Prerenal causes include anything that decreases blood flow to the kidneys such as bleeding, vomiting, diarrhea, sepsis, and NSAIDs.[2] Intrinsic kidney causes include acute tubular necrosis, interstitial nephritis, and glomerulonephritis.[2] Post-renal causes include kidney stones, bladder cancer, and other causes of urinary obstruction.[2] Diagnosis is based on a 50% increase in serum creatinine within 7 days, a 26.5 umol/L (0.3 mg/dL) within 2 days, or a urine output of less than 0.5 mL/kg per hour for at least six hours.[2]
Management in part depends on the underlying cause.[2] If the bladder is blocked, drainage is required.[2] If a person's blood volume is low intravenous fluid are given.[2] If the kidneys themselves are the reason, furosemide or immunosuppressants may be used.[2] Other supportive measures such as a low potassium diet and dialysis may be required.[2] Often it is reversible.[2]
AKI is common, affecting up to 7% of people admitted to hospital and 30% of people admitted to ICU.[2] In hospitalized people 21% of cases are prerenal, 69% are intrinsic kidney, and 10% are post-renal.[2] Of the intrinsic kidney group acute tubular necrosis is the most common cause.[2] Acute kidney injury was described as early as the Byzantine period (330-1452).[3]
References[edit]
- ^ Webb S, Dobb G (December 2007). "ARF, ATN or AKI? It's now acute kidney injury". Anaesthesia and Intensive Care. 35 (6): 843–44. doi:10.1177/0310057X0703500601. PMID 18084974.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa Goyal, A; Daneshpajouhnejad, P; Hashmi, MF; Bashir, K (January 2020). "Acute Kidney Injury". PMID 28722925.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Congress, International Association for the History of Nephrology (1997). History of Nephrology 2: Reports from the First Congress of the International Association for the History of Nephrology, Kos, Greece, October 14-16, 1996. Karger Medical and Scientific Publishers. p. 217. ISBN 978-3-8055-6499-1.