Question

• Summarize acute kidney injury (AKI), include the RIFLE criteria for acute renal dysfunction/failure, and describe the pathophysiology, clinical manifestations, evaluation, and treatment.

Answer 1

Ans. Acute kidney injury : sudden loss of renal function,reversible loss of renal function

It characterised by azotemia(accumulation of nitrogenous waste in blood)

Pathophysiology of acute renal failure 1.:sudden and almost complete loss of glomerular and tubular function

2.progression from anuric or oliguric phase through diuretic phase to convalescent phase (take up to 6 to 12 months before return of function, may progress to chronic renal failure

3.acidosis, potassium intoxication. Pulmonay edema or infection may result in death

Clinical manifestation :subjective data = irritability. Headache.anorexia,nausea, circumoral numbness, tingling of extremities (hypocalcemia) , lethargy, drawziness that can progress from coma

Objectives data= sudden drop in urinary out put, restlessness, twitching, seizures, vomiting, skin pallor, anemia, generalized edema, elevated serum blood uria nitrogen level

Evaluation = physical examination, renal function test, urine analysis, renal biopsy, renalultra sonography

Treatment : diuretic

Limit fluid intake (600 ml +urine output /day)

Calcium supplements +vitamin D

Treatment of hyperkelamia - regular insulin given iv

Calcium gluconate

Sodium bicarbonate

Kayaxalate