Acute Kidney Injury Case Study
1. AKI can be prerenal, intrarenal, and postrenal. Prerenal is a decrease in blood flow to the kidneys and this leads to a decrease in glomerulus perfusion and filtration. During prerenal, Azotemia occurs and is the accumulation of nitrogenous waste in the blood. This results in a reduction in sodium excretion, increased sodium and water retention, and decreased urine output. Intrarenal has direct damage to the kidney. Nephrotoxins can cause structures to crystallize and cause damage to the cells, also hemoglobin and myoglobin can block the tubules. Acute tubular necrosis is the main cause and this is when ischemia disrupts the basement membrane and causes patchy destruction. Postrenal there is a mechanical obstruction …show more content…
Initially, the elevated creatinine and BUN lab values show that she may have ARF. In addition to the lab values, she had a history of congestive heart failure, which is a common cause of prerenal heart failure. Also, she had signs of being in the oliguric stage, such as her nonoliguric output of 510ml/day, her pitting edema, jugular vein distension, crackles bilaterally in the lungs, and changes in potassium (causing longer prolonged QRS and peaked T waves). After her diagnosis, she began to improve because she was in the recovery phase of ARF, where the BUN and creatinine levels begin to fall and CAVHD was no longer …show more content…
Risk factors for nephrotoxicity: comorbidities, volume depletion, liver dysfunction, sepsis, renal dysfunction, hypokalemia, hypomagnesemia, and advanced age ii. Prevention: prevent the accumulation of aminoglycosides in the kidney, lower dosage, and alternative medication
b. Amphotericin B – antifungal
i. Risk factors for nephrotoxicity: therapy with other nephrotoxins and higher dose of amphotericin B ii. Prevention: lower dosages and alternative medication
c. NSAIDs- anti-inflammatory
i. Risk factors for nephrotoxicity: advanced age, liver issues, higher dose of NSAID, and cardiovascular disease ii. Prevention: alternative medication and lower dosages of medication
7. Dopamine is used to improve blood flow and treat symptoms of shock. It could have been prescribed because she was continuously deteriorating and dopamine would help to increase the blood flow to the kidneys and help if she started to go into shock.
8.
a. Diuretics can be given if there is a decrease in urine output, because low urine output is accompanied by fluid retention. The diuretic will remove the fluid that the patient is
1. AKI can be prerenal, intrarenal, and postrenal. Prerenal is a decrease in blood flow to the kidneys and this leads to a decrease in glomerulus perfusion and filtration. During prerenal, Azotemia occurs and is the accumulation of nitrogenous waste in the blood. This results in a reduction in sodium excretion, increased sodium and water retention, and decreased urine output. Intrarenal has direct damage to the kidney. Nephrotoxins can cause structures to crystallize and cause damage to the cells, also hemoglobin and myoglobin can block the tubules. Acute tubular necrosis is the main cause and this is when ischemia disrupts the basement membrane and causes patchy destruction. Postrenal there is a mechanical obstruction …show more content…
Initially, the elevated creatinine and BUN lab values show that she may have ARF. In addition to the lab values, she had a history of congestive heart failure, which is a common cause of prerenal heart failure. Also, she had signs of being in the oliguric stage, such as her nonoliguric output of 510ml/day, her pitting edema, jugular vein distension, crackles bilaterally in the lungs, and changes in potassium (causing longer prolonged QRS and peaked T waves). After her diagnosis, she began to improve because she was in the recovery phase of ARF, where the BUN and creatinine levels begin to fall and CAVHD was no longer …show more content…
Risk factors for nephrotoxicity: comorbidities, volume depletion, liver dysfunction, sepsis, renal dysfunction, hypokalemia, hypomagnesemia, and advanced age ii. Prevention: prevent the accumulation of aminoglycosides in the kidney, lower dosage, and alternative medication
b. Amphotericin B – antifungal
i. Risk factors for nephrotoxicity: therapy with other nephrotoxins and higher dose of amphotericin B ii. Prevention: lower dosages and alternative medication
c. NSAIDs- anti-inflammatory
i. Risk factors for nephrotoxicity: advanced age, liver issues, higher dose of NSAID, and cardiovascular disease ii. Prevention: alternative medication and lower dosages of medication
7. Dopamine is used to improve blood flow and treat symptoms of shock. It could have been prescribed because she was continuously deteriorating and dopamine would help to increase the blood flow to the kidneys and help if she started to go into shock.
8.
a. Diuretics can be given if there is a decrease in urine output, because low urine output is accompanied by fluid retention. The diuretic will remove the fluid that the patient is