El conocimiento de la composición corporal y la distribución de los fluidos en los pacientes renales es de gran importancia en la evolución clínica desde el punto de vista nutricional y de adecuación de la dosis de diálisis. Continue reading
The Banff classification represented the first attempt to formulate an international, consensus based and structured classification system for the diagnosis and categorization of renal allograft biopsy pathology with a particular focus on the development of the morphological criteria for the diagnosis and classification of rejection. Continue reading
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.
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.
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).
RIFLE, a newly developed international consensus classification for acute kidney injury, defines three grades of severity
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