AKI definitions, prerenal, intrinsic and postrenal causes, FeNa and urine sediment findings, contrast and drug nephrotoxicity, and indications for dialysis.
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- By KDIGO criteria, how much must serum creatinine rise within 48 hours to diagnose AKI?
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An increase of 0.3 mg/dL or more- What urine output defines AKI by the KDIGO criteria?
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Less than 0.5 mL/kg/hr for at least 6 hours- What serum creatinine rise defines KDIGO AKI Stage 1?
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1.5 to 1.9 times baseline, or a rise of 0.3 mg/dL or more- What defines KDIGO AKI Stage 3?
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Creatinine 3 times baseline or more, creatinine at least 4.0 mg/dL, or initiation of dialysis- What are the three major categories of AKI causes?
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Prerenal, intrinsic (renal), and postrenal- What is the basic mechanism of prerenal AKI?
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Decreased renal blood flow causing reduced GFR, without direct damage to kidney tissue- Name common causes of prerenal AKI.
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Hypovolemia, heart failure, sepsis, and hemorrhage- In prerenal AKI, what is the typical BUN to creatinine ratio?
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Greater than 20 to 1- What is the formula for fractional excretion of sodium (FeNa)?
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(Urine sodium x Plasma creatinine) divided by (Plasma sodium x Urine creatinine), times 100- What FeNa value suggests a prerenal cause of AKI?
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Less than 1 percent- What FeNa value suggests intrinsic AKI such as ATN?
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Greater than 2 percent- Why is FeNa unreliable in a patient on diuretics?
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Diuretics cause sodium wasting, which falsely raises FeNa regardless of the true cause- When should fractional excretion of urea (FeUrea) be used instead of FeNa?
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When the patient has recently taken diuretics- What FeUrea value suggests a prerenal cause of AKI?
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Less than 35 percent- What does the urine sediment typically show in prerenal AKI?
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Bland sediment with hyaline casts, no cells or significant protein
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