Classifications of Acute Kidney Injury and Chronic Kidney Disease

Recently developed consensus functional definitions on the basis of specific changes in the serum creatinine concentration and urine volume now complement anatomical approaches to diagnosis.

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The Sequential Organ Failure Assessment (SOFA) Score

The SOFA system was created in a consensus meeting of the European Society of Intensive Care Medicine in 1994 and further revised in 1996. The SOFA is a six-organ dysfunction/failure score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal), providing a daily score of 0 to 24 points. The objective in the development of the SOFA was to create a simple, reliable, and continuous score easily obtained in every institution.

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Indications of Dialysis in Renal Failure

Indications of dialysis in acute renal failure (ARF)

  • Severe fluid overload
  • Refractory hypertension
  • Uncontrollable hyperkalemia
  • Nausea, vomiting, poor appetite, gastritis with hemorrhage
  • Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures,
  • Pericarditis (risk of hemorrhage or tamponade)
  • bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding, etc.)
  • Severe metabolic acidosis
  • Blood urea nitrogen (BUN) > 70 – 100 mg/dl Continue reading

Guidelines for Urinary Indices in Acute Renal Failure (ARF)

Guidelines for urinary indices whereby established Acute Renal Failure (ARF) can be distinguished from renal vasoconstriction with intact tubular function (prerenal azotemia).

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Criteria for Chronic Respiratory Failure in Infants and Children

Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children

Clinical criteria

  • Decreased inspiratory breath sounds
  • Increased retractions, use of accessory muscles
  • Cyanosis breathing room air
  • Decreased level of normal activity/function
  • Poor weight gain (mass) (IMPORTANT)

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Knaus Criteria for Multiple System Organ Failure (MSOF)

Multiple systems organ failure is said present when more than one of the system dysfunctions detected by test values exceeding the threshold values.

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King´s College Hospital Criteria for Liver Transplantation in Fulminant Hepatic Failure

Acetaminophen-induced disease

Arterial pH <7.3 (irrespective of the grade of encephalopathy)

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NYHA Functional Classification for Congestive Heart Failure

The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying heart disease (originally cardiac failure), useful for preoperative assessment. It places patients in one of four categories, based on how much they are limited during physical activity:

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Framingham Criteria for Congestive Heart Failure

Diagnosis of CHF requires the simultaneous presence of at least 2 major criteria or 1 major criterion in conjunction with 2 minor criteria.

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Boston Criteria for Diagnosing Heart Failure

The Boston criteria uses the information from history, physical examination, and chest radiography to categorize the diagnosis of heart failure.

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