Acute kidney injury

Rees, Lesley; Brogan, Paul
          A.; Bockenhauer, Detlef; Webb, Nicholas
          J.A.

doi:10.1093/med/9780199601370.003.0129

Paediatric Nephrology (2 edn)

Lesley Rees et al.

https://doi.org/10.1093/med/9780199601370.001.0001

Published online:

01 May 2012

Published in print:

01 August 2012

Online ISBN:

9780191730634

Print ISBN:

9780199601370

- Copyright Page
  - Notes
  - Notes
- Preface to second edition
  - Notes
  - Notes
- Contributors
  - Notes
  - Notes
- Symbols and abbreviations
  - Notes
  - Notes
1 Patient assessment
- Notes
- Notes
2 The neonate
- Notes
- Notes
3 Congenital abnormalities
- Notes
- Notes
4 Urinary tract infection
- Notes
- Notes
5 Enuresis
- Notes
- Notes
6 Homeostasis
- Notes
- Notes
7 Tubular disease
- Notes
- Notes
8 Renal calculi and nephrocalcinosis
- Notes
- Notes
9 Glomerular disease
- Notes
- Notes
10 Systemic disease affecting the kidney
- Notes
- Notes
11 Vasculitis
- Notes
- Notes
12 Infections and the kidney
- Notes
- Notes
13 Renal cystic diseases and ciliopathies
- Notes
- Notes
14 Syndromes associated with renal diseases
- Notes
- Notes
15 Renal tumours
- Notes
- Notes
16 Hypertension
- Notes
- Notes
- Background, pathophysiology, and causes Background, pathophysiology, and causes
  - Background Background
  - Pathophysiology Pathophysiology
    - Paediatric RIFLE (pRIFLE) criteria Paediatric RIFLE (pRIFLE) criteria
  - Causes Causes
    - Pre-renal acute renal failure Pre-renal acute renal failure
    - Renal acute kidney injury Renal acute kidney injury
    - Post-renal acute kidney injury Post-renal acute kidney injury
  - Acute kidney injury in neonates Acute kidney injury in neonates
- Assessment and investigations Assessment and investigations
  - Important points in the history Important points in the history
  - Initial assessment, examination, and resuscitation Initial assessment, examination, and resuscitation
  - Investigations Investigations
    - Initial investigations Initial investigations
    - Further additional investigations depend on clinical presentation Further additional investigations depend on clinical presentation
      - For suspected HUS For suspected HUS
      - For acute nephritis For acute nephritis
      - Infections and acute kidney injury Infections and acute kidney injury
      - For suspected rhabdomyolysis For suspected rhabdomyolysis
      - For tumour lysis For tumour lysis
      - For renal hypouricaemia (a rare cause of AKI) For renal hypouricaemia (a rare cause of AKI)
      - For acute on CKD For acute on CKD
      - For obstruction For obstruction
    - Renal biopsy Renal biopsy
- Management Management
  - Ongoing management, the first 24h Ongoing management, the first 24h
    - Monitoring Monitoring
    - Fluids Fluids
  - Ongoing management, the next 24–48h Ongoing management, the next 24–48h
    - Monitoring Monitoring
    - Conservative management Conservative management
    - Indications for dialysis Indications for dialysis
    - Fluids for the patient on dialysis Fluids for the patient on dialysis
  - Established acute kidney injury Established acute kidney injury
  - The recovery phase The recovery phase
  - Management of electrolyte abnormalities in acute kidney injury before dialysis Management of electrolyte abnormalities in acute kidney injury before dialysis
    - Hyperkalaemia Hyperkalaemia
  - Hyponatraemia Hyponatraemia
  - Hypernatraemia Hypernatraemia
  - Hyperphosphataemia Hyperphosphataemia
  - Hypocalcaemia Hypocalcaemia
  - Acidosis Acidosis
- Hypertension Hypertension
- Nutrition in acute kidney injury Nutrition in acute kidney injury
  - Day 1 Day 1
  - Day 2 Day 2
  - Day 3 Day 3
  - Day 4 onwards Day 4 onwards
- Drug therapy Drug therapy
- Dialysis Dialysis
  - Choice of dialysis Choice of dialysis
- Follow-up of acute kidney injury Follow-up of acute kidney injury
  - Further reading Further reading
- Haemolytic uraemic syndrome: definitions Haemolytic uraemic syndrome: definitions
  - Definitions Definitions
  - Notes on terminology Notes on terminology
- Typical (D+) haemolytic uraemic syndrome: epidemiology and notes Typical (D+) haemolytic uraemic syndrome: epidemiology and notes
  - Clinical features of typical infective haemolytic uraemic syndrome Clinical features of typical infective haemolytic uraemic syndrome
  - Investigations Investigations
    - Selective investigations Selective investigations
  - Treatment Treatment
    - General points General points
    - Blood transfusion Blood transfusion
    - Antibiotics Antibiotics
    - Plasma exchange Plasma exchange
  - Prevention of haemolytic uraemic syndrome Prevention of haemolytic uraemic syndrome
  - Prognosis Prognosis
    - Poor renal prognostic factors Poor renal prognostic factors
    - Outcome following renal transplantation for typical haemolytic uraemic syndrome Outcome following renal transplantation for typical haemolytic uraemic syndrome
  - Further reading Further reading
- Haemolytic uraemic syndrome: atypical Haemolytic uraemic syndrome: atypical
  - Pneumococcal haemolytic uraemic syndrome Pneumococcal haemolytic uraemic syndrome
  - Other causes of atypical haemolytic uraemic syndrome Other causes of atypical haemolytic uraemic syndrome
  - Genetics of haemolytic uraemic syndrome Genetics of haemolytic uraemic syndrome
  - Specific tests to be considered for the investigation of atypical haemolytic uraemic syndrome Specific tests to be considered for the investigation of atypical haemolytic uraemic syndrome
  - Treatment Treatment
  - Prognosis Prognosis
    - Overall patient outcome Overall patient outcome
  - Post-transplant Post-transplant
  - Further reading Further reading
- Rhabdomyolysis Rhabdomyolysis
  - Background Background
  - Presentation Presentation
  - Causes Causes
    - Acquired causes Acquired causes
    - Hereditary causes Hereditary causes
      - Disorders of muscle carbohydrate metabolism Disorders of muscle carbohydrate metabolism
  - General points General points
  - Investigations Investigations
  - Management Management
  - Further reading Further reading
- Tumour lysis syndrome Tumour lysis syndrome
  - Background Background
  - Factors that predispose to tumour lysis syndrome Factors that predispose to tumour lysis syndrome
  - Management Management
  - Prevention Prevention
  - Treatment of established tumour lysis syndrome Treatment of established tumour lysis syndrome
  - Management after haemodialysis Management after haemodialysis
  - Further reading Further reading
- Notes
- Notes
18 Chronic kidney disease
- Notes
- Notes
19 Chronic peritoneal dialysis
- Notes
- Notes
20 Extracorporeal treatment
- Notes
- Notes
21 Transplantation
- Notes
- Notes
22 Drug prescribing
- Notes
- Notes
23 Psychosocial issues
- Notes
- Notes
- Appendix Supplementary information
  - Notes
  - Notes
- Index
  - Notes
  - Notes

Chapter

17 Acute kidney injury

Get access

https://doi.org/10.1093/med/9780199601370.003.0129

Pages

377–408

Published:

May 2012

Extract

Background, pathophysiology, and causes

Background

Acute renal failure (ARF) is a sudden, potentially reversible inability of the kidney to maintain normal body chemistry and fluid balance. It is usually accompanied by oliguria (urine output <0.5mL/kg/h or <1mL/kg/h in a neonate), but polyuric ARF can also occur.

The term ARF is now being replaced by acute kidney injury (AKI). However, pre-renal ARF without renal injury (e.g. hypovolaemia), does not fulfill the definition of AKI.

Pathophysiology

...

The primary event is usually tubular damage, which leads to an adaptive fall in glomerular filtration rate (GFR) due to renal vasoconstriction, to compensate for failure to reabsorb filtered solute. This vasoconstriction may then perpetuate renal damage. For this reason research has focused on vasoactive compounds, such as angiotensin, prostaglandins, adenosine, endothelin, and nitric oxide. The role of inflammatory mediators has also been explored. As yet, there have been no real advances in the prevention/treatment of AKI.

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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always … More

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Contents

17 Acute kidney injury

Extract

Background, pathophysiology, and causes

Background

Pathophysiology

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Contents

17 Acute kidney injury

Extract

Background, pathophysiology, and causes

Background

Pathophysiology

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