Zusammenfassung der Ressource
Acute Kidney Injury
- Structure of uriniferous tubules
- Function of uriniferous tubules
- Proximal convoluted tubule
- Early
- Late
- Loop of Henle
- Thin descending
- water
reabsorption and
solutes secretion
--> hyperosmotic
- Thin ascending
- water
impermeability
and solute
reabsorption -->
hypoosmotic
- Thick ascending
- Distal convoluted tubule
- Early
- Late + collecting duct
- Regulation of body fluid osmolarity
- Causes of renal impairment
- Pre-renal
- Intrarenal
- Tubular
- Drugs, heavy metals, ethylene glycol,
myoglobinuria, radiocontrast dye, urate
- interstitial
- Drug-induced
hypersensitivity (e.g.
NSAIDs, penicillin, and
diuretics)
- glomerular
- Post-renal
- Pathogenesis of Acute Tubular Necrosis
- Injury and necrosis of tubular epithelial cells
- Necrotic cells plug tubules; obstruction decreases
GFR Brown granular casts are seen in the urine
- Dysfunctional tubular epithelium results in
decreased reabsorption of BUN (ratio < 15)
(FENa>2%) (urine osm < 500 mOsm/kg)
- ischemic
- Proximal tubule and medullary
segment of TAL are susceptible
- Nephrotoxic
- Proximal tubule
is susceptible
- Complications of Acute Kidney Injury
- Hyperkalemia
- Pulmonary edema
- Metabolic acidosis
- Hyperphosphatemia
- Management of Acute Kidney Injury
- Diuretics
- CA inhibitors
- Act on PCT
- Osmotic diuretics
- Act on PCT and
thick ascending
- Loop diuretics
- Act on thick ascending (Na-2Cl-K transporter)
- Thiazides
- Early DCT
- K sparing diuretics
- Late DCT and collecting duct