Acute Kidney Injury

Does contrast cause kidney injury? The evidence

We shouldn’t talk about contrasts as one large group. Although there doesn’t seem to be a different between iso-osmolar and low-osmolar groups, a few individual agents appear to be consistently worse. This doesn’t mean that all contrasts result in kidney injury, but based on this data, iohexol and ioxaglate should be avoided.

Does IV contrast cause renal failure?

The question remains whether the observational prospective cohort studies underlying the definition of CI-AKI are convincing enough to support contrast as an independent risk for renal failure.

Acute Kidney Injury – A Simple Emergency Approach to AKI

How comfortable are we in the ED charting anything but ‘pre-renal AKI’ in the patient who’s creatinine surprisingly comes back sky high? Since when did the term ‘multifactorial AKI’ become synonymous with ‘I don’t know why the creatinine is up’? Turns out those brilliant, well-rested nephrologists have been onto something all along.

Acute Kidney Injury: Common Considerations and Complications

. A recently introduced definition of AKI specifies a rise in SCr above baseline of at least 0.3 mg/dL within 48 hours or 50% above baseline within 7 days, or the presence of oliguria (< 0.5 ml/kg/h) for 6 hours. AKI may be subdivided into three broad categories corresponding loosely to the anatomical site of the abnormality or injury.

IMIowa - Internal Medicine Chief Blog

Acute kidney injury occurs in approximately 5% to 7% of hospital admissions and up to 30% of ICU admissions. Kidney Disease Improving Global Outcomes acute kidney injury (AKI) consensus guidelines define AKI as an increase in serum creatinine ≥0.3 mg/dL (26.5 µmol/L) within 48 hours, ≥1.5 times baseline (known to have occurred within the previous 7 days), or urine volume <0.5 mL/kg/h for 6 hours.

Risk of Acute Kidney Injury After Intravenous Contrast Media Administration

In the largest well-controlled study of acute kidney injury following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury.

Acute Kidney Injury: Pearls and Pitfalls

Acute kidney injury (AKI) is a sudden, potentially reversible, kidney dysfunction with partial or complete loss of glomerular filtration resulting in electrolyte and fluid abnormalities as well as retention of nitrogenous waste products

CanadiEM

This chapter covers an approach to acute and chronic kidney injuries, including causes, complications and treatments.

EMCrit

Most cases of AKI will resolve without specific intervention (e.g. with treatment of underlying sepsis). However, occasionally a specific issue is identified which requires specific therapy (e.g. Foley catheter obstruction, glomerulonephritis). Finding these patients is a bit like hunting for a needle in a haystack.

Emergency Medicine Saint John

According to KDIGO guidelines AKI is define as an 1) increase in serum creatinine by ≥0.3 mg/dL (≥26.5 µmol/L) within 48 hours, or 2) an increase in serum creatinine ≥ 1.5 fold from baseline within 7 days, or 3) urine output <0.5 mL/kg/hour for 6 hours.

FOAMcast

typically a creatinine 1.5-2x the patient’s baseline is classified as acute kidney injury. Urine output can be increased initially but determine whether a patient is making urine and how much, as urine output <0.5 mL/kg/h qualifies as AKI.

Life in the Fastlane

AKI is the entire spectrum of disease (mild -> severe), and can be defined as an abrupt (1 to 7 days) and sustained (more than 24 hours) decrease in kidney function.

Kidney.org

Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days.