ACUTE KIDNEY INJURY

ACUTE KIDNEY INJURY Acute Kidney Injury Acute increase in creatinine by at least 50% Post-Renal (Obstruction/hydronephrosis on U/S) Pre-Renal (FeNa < 1%, bland urine sediment) Renal Hypoperfusio n Systemic Hypotension Vascular (Thrombocytopenia and schistocytosis on CBC) Glomerular (RBC casts, dysmorphic RBCs) Interstitial (Sterile pyuria, eosinophiluria) • Hepatorenal syndromes • Drugs • Emboli • Shock Acute Tubular Necrosis (Epithelial cell casts) Tubular Obstruction • Cast nephropathy (multiple myeloma) • Urate crystals • Calcium Oxalate (Ethylene glycol) • Ischemia (severe hypotension) • Toxins (contrast, aminoglycosides, chemotherapy) • Pigments • Anti-GBM antibodies • Immune-complex deposition (IgA, poststrep, lupus) • Pauci-immune (Wegener's) Renal (FeNa > 2%) Tubular TTP/HUS Rapidly Progressive Glomerulonephrit is Acute Interstitial Nephritis • Drugs (NSAIDs, Abx, allopurinol, PPI) • Infections (CMV, strep, legionella) • Immune (lupus, sarcoid, Sjögren) • Shiga-like toxin (E. coli) • Drugs • HIV • Malignancy • Benign Prostatic Hyperplasia • Constipation • Prostate Cancer • Urolithiasis • Cervical Malignancies Urinalysis and CBC