Narrative Review: Acute Kidney Injury: Difference between revisions

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== Diagnosis ==
== Renal dysfunction Definition ==
'''Symptoms:''' 
Persistent decrease in eGFR of > 20 ml/min/1.73 m2 from baseline >48 hours that does not respond to simple measures such as decreasing diuresis or volume replacement). [Note: eGFR via CKD-Epi equation]


O Anuria
=== Acute Kidney Injury (AKI) definition ===
AKI is defined as any of the following (Not Graded):


O Oliguria 
O Increase in SCr by X0.3 mg/dl (≥26.5 μmol/l) within 48 hours; '''or'''


O Flank pain
O Increase in SCr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; '''or'''


O Hematuria
O Urine volume <0.5 ml/kg/h for 6 hours.
 
'''Stage criteria for AKI based on Serum Creatinine'''
 
O '''Stage 1''': 1.5–1.9 times baseline OR ≥0.3 mg/dl (≥26.5 μmol/l) increase
 
O '''Stage 2''': 2.0–2.9 times baseline
 
O '''Stage 3''': 3.0 times baseline OR Increase in serum creatinine to ≥4.0 mg/dl (≥353.6 μmol/l) OR Initiation of renal replacement therapy


'''Laboratory:'''
'''Laboratory:'''
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'''Stage criteria for AKI based on Serum Creatinine'''
O '''Stage 1''': 1.5–1.9 times baseline OR ≥0.3 mg/dl (≥26.5 μmol/l) increase
O '''Stage 2''': 2.0–2.9 times baseline
O '''Stage 3''': 3.0 times baseline OR Increase in serum creatinine to ≥4.0 mg/dl (≥353.6 μmol/l) OR Initiation of renal replacement therapy
== Renal dysfunction Definition ==
Persistent decrease in eGFR of > 20 ml/min/1.73 m2 from baseline >48 hours that does not respond to simple measures such as decreasing diuresis or volume replacement). [Note: eGFR via CKD-Epi equation]
=== Acute Kidney Injury (AKI) definition ===
AKI is defined as any of the following (Not Graded):
O Increase in SCr by X0.3 mg/dl (≥26.5 μmol/l) within 48 hours; '''or'''
O Increase in SCr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; '''or'''
O Urine volume <0.5 ml/kg/h for 6 hours.
== Event(s)==
== Event(s)==
'''Event (1):'''
'''Event (1):'''

Latest revision as of 14:11, 29 June 2018

Narrative Review

Narrative Review: Death

Narrative Review: Stroke

Narrative Review: Myocardial Infarction

Narrative Review: Acute Kidney Injury

Narrative Review: Bleeding

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Site Patient AE Complication Event date AE code
xxx xxx x MM/DD/YYYY xxx

 Renal dysfunction Definition

Persistent decrease in eGFR of > 20 ml/min/1.73 m2 from baseline >48 hours that does not respond to simple measures such as decreasing diuresis or volume replacement). [Note: eGFR via CKD-Epi equation]

Acute Kidney Injury (AKI) definition

AKI is defined as any of the following (Not Graded):

O Increase in SCr by X0.3 mg/dl (≥26.5 μmol/l) within 48 hours; or

O Increase in SCr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or

O Urine volume <0.5 ml/kg/h for 6 hours.

Stage criteria for AKI based on Serum Creatinine

O Stage 1: 1.5–1.9 times baseline OR ≥0.3 mg/dl (≥26.5 μmol/l) increase

O Stage 2: 2.0–2.9 times baseline

O Stage 3: 3.0 times baseline OR Increase in serum creatinine to ≥4.0 mg/dl (≥353.6 μmol/l) OR Initiation of renal replacement therapy

Laboratory:

Date Time BUN/Cr Na/K Urine output Arterial pH HCO3 HgB
MM/DD/YYYY xx:xx
MM/DD/YYYY xx:xx
MM/DD/YYYY xx:xx

 Event(s)

Event (1):

  • Site Reported Event Onset Date: MM/DD/YYYY
  • Event summary:
    • Symptoms and sign:
      • Subject presented with [sign and symptom] on MM/DD/YYYY.
      • Important characteristics of the chief complaint such as severity, site, and duration.
      • Other important symptoms related to the chief complaint.
    • Past Medical History: [eg. CAD, Severe mitral stenosis, former tobacco use, dyslipidemia, ...]
    • Past Surgical History: [including date]
    • Medications: [relevant to the event not all]
    • Physical assessment:
      • Vital signs
      • Positive physical examinations or related negative examinations.

Event (2):

  • Site Reported Event Onset Date: MM/DD/YYYY
  • Event summary:
    • Symptoms and sign:
      • Subject presented with [sign and symptom] on MM/DD/YYYY.
      • Important characteristics of the chief complaint such as severity, site, and duration.
      • Other important symptoms related to the chief complaint.
    • Past Medical History: [eg. CAD, Severe mitral stenosis, former tobacco use, dyslipidemia, ...]
    • Past Surgical History: [including date]
    • Medications: [relevant to the event not all]
    • Physical assessment:
      • Vital signs
      • Positive physical examinations or related negative examinations.

Procedure

  • Index Procedure Date/Time:
    • mm/dd/YYYY at xx:xx [insert date and time]
  • Index Procedure Detail:
    • On mm/dd/YYYY at xx:xx [insert date and time] the subject underwent a [select surgical correction] for [select etiology].
    • Access site details
    • The site reported that there were/were not procedural complication(s). 

Other Laboratory data and Imaging

  • Other laboratory:
    • Date/ name/ value
  • ECG / date:
  • ECHO / date:
  • CXR / date:
  • Other imaging and diagnostic tests / date:

Consults

  • Date and time of consult
  • Suggested treatments

Clinical course

  • Date and time of events:
  • Dialysis / time
  • Patient condition got worse or better.

Treatment and outcome

  • List of relevant medical treatments
  • Outcome [Discharge / Hospice / Death]