Renal Failure PPT PDF

NCM 118 Lec - Renal Failure PPT (M.G.M) Injury: CREATININE CRITERIA: Renal Failure ○ ↑ Serum creatinine increase of 2-3x...

NCM 118 Lec - Renal Failure PPT (M.G.M) Injury: CREATININE CRITERIA: Renal Failure ○ ↑ Serum creatinine increase of 2-3x baseline value reduction in the kidney’s ability to sufficiently URINE OUTPUT CRITERIA: filter waste products from the blood. ○ Urine output < 0.5 mL/kg/hr x 12 Acute Renal Failure (ARF) hours. Abrupt reduction of renal function. Progressive retention of metabolic waste Failure: products CREATININE CRITERIA: (creatinine, urea). ○ ↑ Serum creatinine increase by 3 or Disturbances in electrolyte acid-base more x baseline value or an balance, calcium, homeostasis, increasing value >4 mg/dL with acute phosphate metabolism, blood pressure increase of 0.5 mg/dL or more regulation, and erythropoiesis. URINE OUTPUT CRITERIA: Chronic Renal Failure (CRF) ○ Urine output < 0.3 mL/kg/hr x 24 Presence of kidney damage or hours or anuria x 12 hours. decreased glomerular filtration rate Loss: (GFR) for greater than 3 months. CREATININE CRITERIA: M.G.M ○ Persistent ARF for > 4 weeks. Acute Renal Failure End Stage: ↓ GFR; Hallmark of AKI, reflected by accumulation CREATININE CRITERIA: of : ○ Persistent ARF for > 3 months. Serum Creatinine Provide valuable AKI Staging Criteria : AKIN Criteria (2007) information about the kidney’s filtering ability. Stage 1: Blood Urea Nitrogen CREATININE CRITERIA: Provide valuable ↑ Serum creatinine increase of 1.5-2x baseline value information about the or increase of 0.3 mg/dL or more kidney’s filtering ability. URINE OUTPUT CRITERIA: Azotemia - build up of nitrogen based wastes in the Urine output < 0.5 mL/kg/hr x 6 hours. blood Stage 2: GFR- refers to the rate at which the filtrate is CREATININE CRITERIA: formed (125ml/min in a healthy adult) ↑ Serum creatinine increase of 2-3x baseline URINE OUTPUT CRITERIA: Definition of AKI (KDIGO Guidelines) Urine output < 0.5 mL/kg/hr x 12 hours. 1. Increase in Serum Creatinine Level: Stage 3: By ≥0.3 mg/dL (≥26.5µmol/L) within CREATININE CRITERIA: 48 hours. ↑ Serum creatinine increase of 3x baseline or >4 2. Increase in Serum Creatinine Level: mg/dL with acute increase of 0.5 mg/dL By ≥1.5 times compared to baseline URINE OUTPUT CRITERIA: within the last 7 days. Urine output < 0.3 mL/kg/hr x 24 hours or anuria x 3. Urine Volume less than or equal to 0.5 mL/kg/hr ≥ 12 hours. for 6 hours AKI Staging Criteria : KDIGO Criteria AKI Staging Criteria: RIFLE Criteria (2004) Stage 1: Risk: CREATININE CRITERIA: CREATININE CRITERIA: ↑ in Screa 1.5 - 1.9 x baseline or ≥ 0.3 md/dL ○ ↑ Serum creatinine increase of increase within 48 hours. 1.5-2x baseline value; URINE OUTPUT CRITERIA: URINE OUTPUT CRITERIA: < 0.5 mL/kg/hr x 6-12 hours ○ Urine output < 0.5 mL/kg/hr x 6 hours. Stage 2: Conditions that can cause damage to kidneys and CREATININE CRITERIA: lead to AKI: Increase in Screa of 2.0-2.9 compared to baseline Ischemic within the previous 7 days. ○ Prolonged decreased renal perfusion URINE OUTPUT CRITERIA: ○ Septic shock < 0.5 mL/kg/hr x ≥ 12 hours ○ Transfusion reaction ○ Trauma/crush injury Stage 3: Nephrotoxic CREATININE CRITERIA: ○ Antibiotics/fungicides/gram(-) toxins Screa increase of 3 or more x baseline value or an ○ Pesticides increasing value ≥ 4.0 mg/dL or initiation of RRT in ○ Radiographic dyes patients in < 18 years, decrease in eGFR to Inflammatory 2 35mL/min per 1.73𝑚 ○ Acute glomerulonephritis/ Acute URINE OUTPUT CRITERIA: tubular necrosis