ACEI

• What type of AKI
• How?

• Prerenal
• Dialates efferent arteriole

ARBS

• What type of AKI
• How

• Prerenal
• Dilates Efferent arteriole

NSAIDS

• What type of AKI?
• How?

• Prerenal
• Prevent dilation of afferent arteriole

Aminoglycoside (AG)

• Causes what kind of AKI?
• How

• ATN intrinsic
• Damage to epithelial cells of proximal tubule

Amphotericin B (AMB)

• What kind of AKI?
• How?

• ATN intrinsic
• creates pores in distal tubule.  Necrosis

Cisplatin (C)

• What type of AKI
• How?

• ATN intrinsic
• creates reactive species, cell apoptosis

Contrast media

• What type of AKI?
• How?

• ATN intrinsic
• toxic to proximal tubule,

Sulfonamides

• What type of AKI?
• How?

• Postrenal
• kidney stones

Anticholinergic medications

• What type of AKI?
• How?

• Postrenal AKI
• prevention of urination

(UNa/SNa) X100

(UCr/SCr)

Pre-renal

• BUN : SCr
• FE_Na
• Hyaline casts
• Protein

• BUN : SCR >20
• FE_Na <1%
• No casts
• No protein

Intrinsic ATN

• BUN : SCr
• FE_Na
• Hyaline casts
• Protein

• BUN : SCr <20:1
• FE_Na >2
• Brown granular casts
• No Protein

Intrinsic Nephrotic

• BUN : SCr
• casts
• Protein
• Proteinurea
• Inflamation?

• BUN : SCr <20:1
• granular casts
• Protein: >100 mg/dl
• proteinurea >3.5 g/day
• No inflamation

Intrinsic Nephritic

• BUN : SCr
• casts
• Protein
• Proteinurea
• Inflamation?

• BUN : SCr <20:1
• Granular casts
• Protein: >100 mg/dl
• Proteinurea: 1.5-3 g/day
• Inflamation

(140-Age)X(BW) (0.85 if woman)

(SCR)X72

When do you use:

• TBW
• IBW
• ABW

• TBW: if IBW>TBW (skinny)
• IBW: if IBW < TBW < 120% IBW (fat)
• ABW: TBW > 120% IBW (Obese)

Hemodialysis

• +
• -

<+>

• nursing staff = accuracy & good monitoring

<->

• multi long visits each week
• Hypotension & muscle cramps
• High rick of infection
• Renal function decline b/c buildup

Peritoneal Dialysis

<+>

<->

<+>

• good preservation of renal function
• convenient
• no heparinization needed

<->

• Risk of infection
• Loss of apetite
• technique failure
• non compliance

• Anemia
• Hypertension
• Hypercholesterolemia