Scribd
Upload
261 views1 page

AKI Flowchart

This document provides an overview of the etiologies, workup, and treatment approaches for pre-renal, intrinsic renal, and post-renal acute kidney injury. Pre-renal causes include volume depletion, heart failure, liver disease, and medications/toxins. Intrinsic renal etiologies involve glomerular, interstitial, and tubular damage from conditions like glomerulonephritis, autoimmune disease, and medications. Post-renal AKI is caused by urinary tract obstruction from issues like prostate enlargement or kidney stones. Evaluation involves history, physical exam, urine analysis, electrolytes, and imaging tests. Management focuses on treating the underlying cause, IV fluids, stopping offending

Uploaded by

Tush Rame
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
261 views1 page

AKI Flowchart

This document provides an overview of the etiologies, workup, and treatment approaches for pre-renal, intrinsic renal, and post-renal acute kidney injury. Pre-renal causes include volume depletion, heart failure, liver disease, and medications/toxins. Intrinsic renal etiologies involve glomerular, interstitial, and tubular damage from conditions like glomerulonephritis, autoimmune disease, and medications. Post-renal AKI is caused by urinary tract obstruction from issues like prostate enlargement or kidney stones. Evaluation involves history, physical exam, urine analysis, electrolytes, and imaging tests. Management focuses on treating the underlying cause, IV fluids, stopping offending

Uploaded by

Tush Rame
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

Pre-Renal Intrinsic Renal Post-Renal

Glomerular Interstitial Tubular Misc/Meds

ETIOLOGY Volume depletion RPGN: Meds (75%) Sepsis/Hypotension Myoglobin BPH


Cardiorenal Post-infectious GN ABX: PCN/Cephal. Peri-Operative Bilirubin Bladder mass
Hepatorenal ANCA-assoc PPI, NSAIDs Meds/Toxins Uric Acid Nephrolithiasis
(Nephrotic syndrome) Lupus nephritis Allopurinol TLS, acute gout,
IgA Autoimmune d/o Lesch-Nyhan
Anti-GBM SLE, Sjogren’s Medications
MPGN/cryo Sarcoidosis
ATN: MCD, MN TINU syndrome
Work-Up Hx/PE
BUN/Cr > 20:1 Nephritic: hematuria Dx of exclusion, FENa > 2% Myoglobin: Hx
sub-nephrotic proteinuria clinical suspicion FEUN > 50% CK, UA Renal U/S
Urine Micro: dysmorphic Hx: Rash, fever, FEUA > 20% “Type IV RTA”
RBC, RBC cast (rare) eosinophilia (~10%) Bilirubin:
7-10 days after drug Urine Micro: RTE cells, > 30, UA
Nephrotic: proteinuria (+) urine eos casts
often > 10g/day Hansel: ~80% sens. Uric Acid:
UNa < 20 mEq/L Hypoalbuminemia Wright: ~60% sens. > 15mg/dl
FENa < 1% Hyperlipidemia NSAIDs, sarcoidosis Spot urine UA/Cr>1
In pts on diuretics? Urine Micro: lipid droplet NOT eosinophilic UA: often normal
FEUN < 35% ATN casts FENa > 1% due to
FEUA < 10% tubular damage
Serologies Isosthenuria
Urine SG, UOsm
Large kidneys on U/S
Urine Micro: Bland/ Urine Micro: WBCs,
Squam. Epith. Cells WBC casts

Treatment Volume expansion GN specific treatment Supportive Care All: IVF to increase Relieve
Diuresis, improve CO HD renal perfusion and obstruction
HRS: STOP DRUG Lasix PRN UOP
Midodrine 7.5 – 12.5mg TID Steroids 1mg/kg/d No forced diuresis ?Bicarb: may promote
Octreotide (100-200 mcg SC TID) max 60mg for 1-2wks Ca-Phos stones
Norepi Rasburicase/allopurinol
Goal: inc MAP 10 mmHg

You might also like