SUMMARY :CARE OF PATIENTS WITH Acute Kidney Injury
(AKI) AND Chronic Kidney Disease (CKD )
Document also with 35 Question & Correct Answers latest on (AKI & CKD)
Definition of Acute Kidney Injury (AKI)
● Rapid loss of renal function due to damage to the kidneys
- Buildup of waste products in the blood
• Urea
• Creatinine
- Fluid and electrolyte imbalances
- Metabolic acidosis
● Can be reversible if caught early and cause treated
*Mastice: Most common in the acute care setting
Affects many body systems Comes on quickly; kidneys are not able to filter the blood as they
normally do. Urea is the end product of protein metabolism. Creatinine is an end product of
muscle breakdown.
- Potassium is excreted by the kidney if the kidney is not working you will
see hyperkalemia.
- Fluid overload another common occurrence, edema, dependent Edema,
adventitious lung sounds (rales, stridor)
- Decrease in RBC & Hematocrit from hemodilution
- Metabolic acidosis: K+ re-enter the RBC in exchange for H+ ions creating
a temporarily acidosis state.
- In acute kidney injury this can be reversible if it caught early importance
of trending lab values. You can catch it early and reverse the kidney injury.
Categories of AKI: Prerenal, Intrarenal, Postrenal
• The Kidney and Nephron
Mastice Notes: Left ventricle pumps oxygen rich blood with waste products through the aorta
via the renal artery to the kidneys
Blood is filtered through the nephrons where glomeruli re-absorption and excretion takes place
Blood without the waste is returned via the renal veins
Prerenal: any problem that arises before the renal artery upward to the heart
AKI Categories
Prerenal AKI( Occurs in the heart and then aorta and then kidney)
● Hypoperfusion to the kidneys
– Occurs in 60-70 percent of cases
– Leads to a decrease in GFR
Mastice: Hypoperfusion: decreased blood flow to the kidneys; kidney deprived of nutrients;
,eventually leads to intrarenal failure (damage to glomeruli or tubules)
, Causes of Prerenal AKI
● Volume depletion
- GI losses (vomiting, diarrhea, NGT suction)
- Hemorrhage
- Renal losses (diuretics, osmotic diuresis)
- Burns
• Impaired cardiac efficiency
- Cardiogenic shock
- Dysrhythmias
- HF
- MI
• Vasodilation from
- Anaphylaxis
- Antihypertensives resulting in hypotension
- Sepsis
- Shock
• Renal artery stenosis
- Before the kidney cause problems with the kidney.
Notes: Many elderly patients suffer from dehydration due to taking Lasix for heart failure. And
they don’t like to drink water because of frequency of bathroom trips and a decrease thirst drive.
Burn victim have poor perfusion in acute phase of the burn.
Cardiogenic shock: inadequate contractility
Dysrhythmias: AFIB: upper chambers of the heart stop pumping and quiver; No blood flow
into the kidney. tachydysrhythmias, heart bocks, VT, Vfib
Vasodilation from: Anaphylaxis: vasodilation causes hypotension from histamines,
prostaglandins bloods pool from artery and vein and doesn’t pump to the kidney.
Vasodilation from: Antihypertensive meds/other causes hypotension…nitroglycerin,
nitroprusside, hydrolazine)
Sepsis, shock due to hypotension
Intrarenal AKI
● Damage to the glomeruli or kidney tubules
- Decreased ability of filter blood
- Excessive waste buildup
- Excessive water buildup
- Problems with electrolyte balance
- Results in decreased GFR, progressive azotemia, F&E imbalances
Mastice: Azotemia build up of nitric problem in the blood. That leads to skin problem.
Causes of Intrarenal AKI
(AKI) AND Chronic Kidney Disease (CKD )
Document also with 35 Question & Correct Answers latest on (AKI & CKD)
Definition of Acute Kidney Injury (AKI)
● Rapid loss of renal function due to damage to the kidneys
- Buildup of waste products in the blood
• Urea
• Creatinine
- Fluid and electrolyte imbalances
- Metabolic acidosis
● Can be reversible if caught early and cause treated
*Mastice: Most common in the acute care setting
Affects many body systems Comes on quickly; kidneys are not able to filter the blood as they
normally do. Urea is the end product of protein metabolism. Creatinine is an end product of
muscle breakdown.
- Potassium is excreted by the kidney if the kidney is not working you will
see hyperkalemia.
- Fluid overload another common occurrence, edema, dependent Edema,
adventitious lung sounds (rales, stridor)
- Decrease in RBC & Hematocrit from hemodilution
- Metabolic acidosis: K+ re-enter the RBC in exchange for H+ ions creating
a temporarily acidosis state.
- In acute kidney injury this can be reversible if it caught early importance
of trending lab values. You can catch it early and reverse the kidney injury.
Categories of AKI: Prerenal, Intrarenal, Postrenal
• The Kidney and Nephron
Mastice Notes: Left ventricle pumps oxygen rich blood with waste products through the aorta
via the renal artery to the kidneys
Blood is filtered through the nephrons where glomeruli re-absorption and excretion takes place
Blood without the waste is returned via the renal veins
Prerenal: any problem that arises before the renal artery upward to the heart
AKI Categories
Prerenal AKI( Occurs in the heart and then aorta and then kidney)
● Hypoperfusion to the kidneys
– Occurs in 60-70 percent of cases
– Leads to a decrease in GFR
Mastice: Hypoperfusion: decreased blood flow to the kidneys; kidney deprived of nutrients;
,eventually leads to intrarenal failure (damage to glomeruli or tubules)
, Causes of Prerenal AKI
● Volume depletion
- GI losses (vomiting, diarrhea, NGT suction)
- Hemorrhage
- Renal losses (diuretics, osmotic diuresis)
- Burns
• Impaired cardiac efficiency
- Cardiogenic shock
- Dysrhythmias
- HF
- MI
• Vasodilation from
- Anaphylaxis
- Antihypertensives resulting in hypotension
- Sepsis
- Shock
• Renal artery stenosis
- Before the kidney cause problems with the kidney.
Notes: Many elderly patients suffer from dehydration due to taking Lasix for heart failure. And
they don’t like to drink water because of frequency of bathroom trips and a decrease thirst drive.
Burn victim have poor perfusion in acute phase of the burn.
Cardiogenic shock: inadequate contractility
Dysrhythmias: AFIB: upper chambers of the heart stop pumping and quiver; No blood flow
into the kidney. tachydysrhythmias, heart bocks, VT, Vfib
Vasodilation from: Anaphylaxis: vasodilation causes hypotension from histamines,
prostaglandins bloods pool from artery and vein and doesn’t pump to the kidney.
Vasodilation from: Antihypertensive meds/other causes hypotension…nitroglycerin,
nitroprusside, hydrolazine)
Sepsis, shock due to hypotension
Intrarenal AKI
● Damage to the glomeruli or kidney tubules
- Decreased ability of filter blood
- Excessive waste buildup
- Excessive water buildup
- Problems with electrolyte balance
- Results in decreased GFR, progressive azotemia, F&E imbalances
Mastice: Azotemia build up of nitric problem in the blood. That leads to skin problem.
Causes of Intrarenal AKI
