Acute Kidney Injury (AKI)

Acute Kidney Injury (AKI)

• AKI is a sudden renal damage that occurs when the kidneys are unable to perform their functions, including filtering the blood, removing waste products and excess fluids, and regulating electrolyte levels.

Types of AKI

Prerenal AKI

• Occurs before the kidneys, due to decreased perfusion
• Causes:
  • Low blood pressure (BP) leading to low perfusion, resulting from shock, hypovolemia, or dehydration due to blood or volume loss
  • Obstruction blocking blood flow and oxygen, resulting from emboli, clots, or tumors
  • Low mean arterial pressure (MAP) ≤ 1.3, indicating poor kidney function

Postrenal AKI

• Occurs after the kidneys, due to mechanical obstruction in the urinary tract
• Causes:
  • Benign prostatic hyperplasia (BPH), prostate cancer, or stones
  • Elevated creatinine levels (> 1.3), indicating poor kidney function
  • Elevated blood urea nitrogen (BUN) levels (> 20), indicating poor kidney function
  • Decreased urine output

Anemias

Iron Deficiency Anemia

• Most common type of anemia worldwide
• Caused by inadequate iron intake, poor absorption, or chronic blood loss
• Characterized by microcytic and hypochromic red blood cells
• Low serum iron levels and increased total iron-binding capacity
• Symptoms include fatigue, weakness, shortness of breath, and pale skin
• Treatment involves iron supplements and dietary changes to increase iron intake

Vitamin Deficiency Anemia

• Caused by deficiencies in vitamin B12 and folate
• Characterized by macrocytic red blood cells and hypersegmented neutrophils
• Elevated homocysteine levels
• Symptoms include fatigue, weakness, shortness of breath, pale skin, and neurological symptoms in B12 deficiency
• Treatment involves vitamin supplements and dietary changes to increase vitamin intake

Sickle Cell Anemia

• Genetic disorder affecting hemoglobin production
• Caused by mutation in HBB gene
• Characterized by abnormal hemoglobin production and sickling of red blood cells
• Chronic hemolysis and recurring episodes of pain
• Symptoms include fatigue, jaundice, and increased risk of infections
• Treatment involves pain management, blood transfusions, hydroxyurea therapy, and bone marrow transplantation in severe cases

Anemia of Chronic Disease

• Caused by chronic inflammation or infection
• Characterized by normocytic or microcytic red blood cells and low serum iron levels
• Elevated hepcidin levels
• Symptoms include fatigue, weakness, shortness of breath, and pale skin
• Treatment involves underlying disease management, iron supplements if necessary, and erythropoiesis-stimulating agents (ESAs)