In 2004, the ADQI group and representatives from three nephrology societies established the Acute Kidney Injury Network (AKIN). Its intentions are to facilitate international, interdisciplinary and intersocietal collaborations and to ensure progress in the field of AKI, including the development of uniform standards for the definition and classification of AKI. As part of this process, the RIFLE nomenclature and classification was modified to a staging/classification system differentiating between AKI stage I, II and III. In addition, a 48-hour time window for the diagnosis of AKI was introduced to ensure that the process was acute.
Bartter’s syndrome is a rare disease that most often presents in the neonatal period or early childhood with polyuria, polydipsia, salt craving, and growth retardation. Blood pressure is normal or low. Metabolic abnormalities include hypokalemia, hypochloremic metabolic alkalosis, decreased urinary concentrating and diluting ability, hypercalciuria with nephrocalcinosis, mild hypomagnesemia, and increased urinary prostaglandin excretion.
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 whereby established Acute Renal Failure (ARF) can be distinguished from renal vasoconstriction with intact tubular function (prerenal azotemia).
Contrast-induced nephropathy (CIN) is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine (SCr) from baseline or 0.5 mg/dL (44 umol/L) increase in absolute value, within 48-72 hours of intravenous contrast administration. Continue reading
RIFLE, a newly developed international consensus classification for acute kidney injury, defines three grades of severity
Indications for percutaneous needle biopsy include
Clinical Features of Nephrotic Syndrome
The nephrotic syndrome is a clinical complex characterized by:
- proteinuria of >3.5 g per 1.73 m2 per 24 h (in practice, >3.0 to 3.5 g per 24 h),
- lipiduria, and
NKF Definition of Chronic Kidney Disease
Kidney damage for three or more months, as defined by structural or functional abnormalities of the kidney, with or without decreased GFR, manifested by pathologic abnormalities or markers of kidney damage, including abnormalities in the composition of the blood or urine or abnormalities in imaging tests
GFR < 60 mL per minute per 1.73 m2 for three months or more, with or without kidney damage
Acute kidney injury (AKI) is a common complication in patients with end-stage liver disease and advanced cirrhosis regardless of the underlying cause. Hepatorenal syndrome (HRS), a functional form of kidney failure, is one of the many possible causes of AKI.