Prerenal Acute Kidney Injury Pathophysiology and Presentation
- Decreased Renal Perfusion
- Decreased GFR
- Increased Sodium and Water Reabsorption
- Edema
- Dyspnea
- Hypotension with Tachycardia
- Altered Mental Status
- Oliguria
- NSAIDs
- Renal Artery Stenosis
- ACE Inhibitors
Prerenal Acute Kidney Injury Diagnosis and Management
- BUN:Creatinine Ratio > 20:1
- Fractional Excretion of Sodium (FENa) < 1%
- Urine Osmolality > 500 mOsm/kg
- Hyaline Casts
- Fluid Replacement
- Monitor Renal Function
- Diuretics
Acute Tubular Necrosis
- Ischemic Injury
- Nephrotoxic Injury
- Granular Muddy Brown Casts
- Intrinsic Renal Failure
- Oliguric Phase
- Metabolic Acidosis
- Hyperkalemia
- Increase in BUN and Creatinine
- Polyuria Phase
- Decrease in BUN and Creatinine
- Hypokalemia
- Supportive Care
Autosomal Dominant Polycystic Kidney Disease
- Autosomal Dominant
- Mutations in PKD1/2
- Cystic Enlargement of Renal Tubules
- Chronic Kidney Disease
- Hypertension
- Mitral Valve Prolapse
- Hepatic Cysts
- Berry (Saccular) Aneurysms
Casts in Urine (Differential Diagnosis)
- RBC Casts
- Glomerular Disease
- WBC Casts
- Acute Interstitial Nephritis
- Acute Pyelonephritis
- Fatty Casts
- Maltese Cross Sign
- Nephrotic Syndrome
- Granular Muddy Brown Casts
- Acute Tubular Necrosis (ATN)
- Waxy Casts
- End Stage Renal Disease (ESRD) (Chronic Renal Failure)
- Hyaline Casts
- Non-Specific