Acute Kidney injuryPresented by: Ghiada Al-Rashed

Objectives:

What is acute kidney injury and its classification ?

Kidney function

Secretion of three different hormones:

Secretion FunctionExcretion Function

Renin: regulate blood pressure

Vitamin D: regulate calcium uptake

Excretion product of the kidney: urine

EPO: regulate red blood cell production

Remove excess fluid

Remove waste

productsUrea & Creatinine

Regulate acid/base balance

Regulate electrolyte levels

3

Acute kidney injury Defined as an abrupt or rapid decline in renal

filtration function. 

Is reversible over a period of days or weeks.

AKI is life threating injury and medical emergency.

AKI severe enough to result in accumulation of nitrogenous waste in the body; urea URAEMIA

AKI marked by a rise in serum creatinine concentration

AKI may cause sudden, life threatening biochemical disturbances MEDICAL EMERGENCY

AKI cause reduce Glomerular Filtration Rate ….decreased urine excretion OLIGURIA

Serum creatinine & urine output should continue to be viewed as the best existing

markers for AKI

Acute kidney injury

Hospitalized patients (elderly and ICU).

Lead to chronic kidney disease (CKD) or kidney failure.

This can also affect other organs such as the brain, heart, and lungs.

:Signs and symptoms

Decreased urine output Fluid retention Drowsiness Confusion Nausea Seizures or coma in severe cases Fatigue Shortness of breath Chest pain or pressure

Classification of acute kidney injury

AKI

RIFLE classification

AKIN classification

RIFLE classification of acute kidney injury

• RIFLE criteria induce an increasing the degree of renal damage.

• FOR grades the severity

• on the basis of either increase in serum creatinine, decrease in GFR or decreased urine output.

• Three level of renal dysfunction ( R, I, F) Risk Injury Failure • Two outcome measure ( L, E) : Loss End-stage renal disease

RIFLE classification of acute kidney injury

AKIN classification of acute kidney injury

Modification of the RIFLE classification by ( Acute Kidney Injury Network (AKIN) .

For staged the severity ( not grade)

Recognizes that small changes in serum creatinine (>0.3 mg/dl) adversely impact clinical outcome.

R in (RIFLE classification) stage 1 I in (RIFLE classification) stage 2 F in (RIFLE classification) stage 3

AKIN classification of acute kidney injury

Take home massage Acute kidney injury is sudden loss of kidney

function.

There several causes of Acute kidney injury include less blood flow to kidney OR damage to the kidney OR block of urine from kidney.

When the kidney dose not function well the west product build up in the body.

If un-treated it will lead to death.

References:

Chapter 12