Acute kidney injury

Autoregulation of the kidney
1. High blood pressure
  1. High renal flow (high renal artery pressure)
    1. High GFR
      1. High tubular flow (No reabsorption of Na)
        High NaCl (High solute load)
        Macula densa (Very sensitiive to Na in DCT)
        Secretes PRODUCTS
        Afferent arteriole constriction
        Efferent arteriole dilation
2. Myogenic hypothesis
  1. Stretching of vessels due to increased pressure cause vasoconstriction which keeps the RBF constant.
Presentation
1. Insomnia
  1. Oliguria
    1. Nausea and vomiting
      1. Hyperventilation
        Shock
        Causes
        Burns
        Infections
        Vomiting
        Spinal injury
        Hemorrhage
        Types
        Septic
        Anaphylactic
        Cardiogenic
        Hypovolemic
        Splenic injury
        Causes
        Penetrating trauma
        Indirect trauma
        Blunt trauma
        Infections
        Management
        Operation
        Fluids
        Blood transfusion
        Heart transplant
        Catheter
        H2 blockers
        Steroids
        Antibiotics
Causes in the picture
Complications
1. Fluid buildup
  1. Kidney damage
    1. Chest pain
      1. Muscle pain
        Death
Manage,ment
1. Dialysis
  1. Diuretics
    1. Life style changes
      1. Statins
        ACE inhibitors
        Restore Ca and K levels
        Fluid resustication
      2. Healthy diet
      3. Exersice
Cause
1. Acute tubular necrosis
  1. Signs and symptoms
    1. High BUN
      1. Brown granular casts
        High urine osmolarity
  2. Nephrotoxic
    1. May be toxin mediated
    2. Extensive continous necrosis
    3. Intact basement membrane
  3. Ischemic
    1. Patchy tubular epithelialnecrosis
    2. Rupture of the basement membrane
  4. Injury and necrosis of tubular epithelial cells
Can lead to:
1. Acid-base disturbance
  1. Important Questions to ask!
    1. What is the osis? (Alkalosis or Acidosis)
    2. What is the cause of the osis?
    3. Was there compensation?
What are the functions that can be impaired? (Picture)

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Acute kidney injury

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	Created by fatima alkhateeb over 6 years ago