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__NOTOC__ 
{{CMG}}; {{AE}} {{NN}}


'''<font size="4">[[Acute Kidney Injury]]</font>'''
 
----
 
<br><br>
 
'''<font size="3">Overview</font>'''
__NOTOC__
{{CMG}}; {{AE}} {{NN}}<br>
----
----


Acute kidney injury (AKI) or acute renal failure (ARF), is characterized by a rapid reduction of the renal filtration function, which is identified by a rise in serum creatinine concentration.<ref name="pmid15232604">{{cite journal| author=Schrier RW, Wang W, Poole B, Mitra A| title=Acute renal failure: definitions, diagnosis, pathogenesis, and therapy. | journal=J Clin Invest | year= 2004 | volume= 114 | issue= 1 | pages= 5-14 | pmid=15232604 | doi=10.1172/JCI22353 | pmc=437979 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15232604  }} </ref> <br><br>'''<font size="3">Historical Perspective</font>'''
 
----<br><br>
 
'''<font size="3">Classification</font>'''
 
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{{familytree/start}}{{familytree | | | | | | | | | A01 | | | | | |A01=  [[COVID-19]]  }}
*Acute kidney injury is classified into three main groups:<br>1. Prerenal<br>2. Renal<br>3. Postrenal<br>
{{familytree | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|.| }}
{| border="1"
{{familytree | |  C01  | | | | | | | | | | | | C02 |C01=  '''30-40%'''  <br> [[Asymptomatic]]|C02= '''60-70%''' <br> [[Symptomatic]]}}
|+ '''lab findings in AKI'''
{{familytree | | |!| | | | | | | | | |,|-|-|-|+|-|-|-|-|.|}}
! Type !! UOsm !! UNa !! FeNa !! BUN/Cr
{{familytree | | E01 | | | | | | | | E02 | | E03 | | | E04 |E01=[[Asymptomatic carrier]]|E02='''80%''' <br> Mild symtoms|E03='''14%''' <br> Severe symptoms|E04='''6%''' <br> Critically ill}}
{{familytree | | | | | | | | | | | | |!| | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | F01 | | F02 | | | F03 |F01=[[Fever]]<br> [[Chills]]<br> [[Cough]]<br> [[Headache]]<br> [[Sore throat]]<br> [[Nasal congestion]] or secretion <br> [[Fatigue]]<br> [[Body aches]]<br> [[loss of taste]] or [[smell]]
<br> [[Nausea]] or [[vomiting]] <br> [[Diarrhea]]<br> |F02=Severe [[Dyspnea]]<br> [[Chest pain]]<br> Severe [[weakness]] <br> new [[Confusion]]<br> Central [[Cyanosis]]
|F03=Death}}
{{familytree/end}}
 
 
 
{| class="wikitable"
! colspan=4 style="background: #4479BA; color: #FFFFFF; " align="center"|CT manifestations of COVID-19
|-
!style="background: #4479BA; color: #FFFFFF; " align="center" |CT findings
!style="background: #4479BA; color: #FFFFFF; " align="center" |Definition
!style="background: #4479BA; color: #FFFFFF; " align="center" |CT picture
|-
|-
! Prerenal
|style="background: #DCDCDC; |'''[[Ground glass opacity]]'''
| >500 || <10 || <1% || >20
|  
*Hazy opacity in the lungs with well defined bronchial and vascular margins 
*the most common imaging finding
*due to infection, chronic interstitial lung disease, and acute lung injury
 
|[[File:Covid-19-pneumonia-26.jpg|200px|thumb|center]]
|-
|-
! Renal
|style="background: #DCDCDC; |'''[[Consolidation]]'''
|<350 || >20  || >2%  ||<10-15
|
*a parenchymal density with ill-defined bronchial and vascular margins
*filling with infectious material [fluid, cells, tissue]
* due to cellular exudates in alveoli
|[[file
|-
|-
!Postrenal
|style="background: #DCDCDC; |''' [[Crazy paving pattern]] '''
| <350 || >40 || >4% ||  >20
|
|}
* Septal thickening of inter and intra-lobar regions
<br />
* with the background of the Ground glass opacity
{| class="wikitable"
* Similar to paving stones
|+
* Due to alveolar edema and acute inflammation of the lung
!Type
* Sign of progression
!UOsm
|[[File:Covid-19-pneumonia-122.jpg|200px|thumb|center]]
!UNa
 
!FeNa
 
!BUN/Cr
|-
|-
|Prerenal
|style="background: #DCDCDC; |''' [[Reticuldar]] pattern '''
|>500
|
|<10
*Linear opacities in the lungs
|<1%
*Due to Interstitial thickening of inter and intralobular septa
|>20
 
|[[file
 
|-
|-
|Renal
|style="background: #DCDCDC; |'''[[Air bronchogram]] '''
|<350
|
|>20
* Air-filled bronchi
|>2%
*Low attenuated areas in the lung
|<10-15
|[[file
 
|-
|-
|Postrenal
|style="background: #DCDCDC; |''' [[Bronchiectasis]] '''
|<350
|
|>40
*irreversible dilatation of the lung airways
|>4%
* Bronchus diameter more than 1.5 cm
|>20
*due to inflammation, obstruction and impaired clearance
|[[file
|}
|}
*Acute kidney injury is classified into three main groups:
**[[Prerenal]]
**[[Renal]]
**[[Postrenal]]<br><br>
{{Family tree/start}}
{{familytree | | | | | | | | | B01 | | | | | |B01=<font color="blue">AKI</font>}}
{{familytree | | |,|-|-|-|-|-|-|+|-|-|-|-|-|-|.| }}
{{familytree | | C01 | | | | | C02 | | | | | C03 |C01=[[Prerenal]]|C02=[[Renal]]|C03=[[Postrenal]]}}
{{Family tree| | | | | | | | | |!| | | | | | | | }}
{{familytree | | |,|-|-|-|-|-|-|+|-|-|-|-|-|-|.| }}
{{Family tree| | |D01 | | | | D02 | | | | D03| | D01=•[[Nephrotoxicity]]<br>• contrast dyes<br>• [[Rhabdomyolysis]]<br>|D02=• [[Ischemia]]<br>• [[Hypoxia]]<br>• Hypotension<br>|D03=• [[Inflammation]]<br>• [[Sepsis]]<br>• [[Infection]]<br>}}
{{Family tree/end}}<br><br><br>
[[File:Etiologies of AKI.jpg]]

Latest revision as of 13:33, 15 July 2020



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nasrin Nikravangolsefid, MD-MPH [2]




 
 
 
 
 
 
 
 
COVID-19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
30-40%
Asymptomatic
 
 
 
 
 
 
 
 
 
 
 
60-70%
Symptomatic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Asymptomatic carrier
 
 
 
 
 
 
 
80%
Mild symtoms
 
14%
Severe symptoms
 
 
6%
Critically ill
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fever
Chills
Cough
Headache
Sore throat
Nasal congestion or secretion
Fatigue
Body aches
loss of taste or smell
Nausea or vomiting
Diarrhea
 
Severe Dyspnea
Chest pain
Severe weakness
new Confusion
Central Cyanosis
 
 
Death


CT manifestations of COVID-19
CT findings Definition CT picture
Ground glass opacity
  • Hazy opacity in the lungs with well defined bronchial and vascular margins
  • the most common imaging finding
  • due to infection, chronic interstitial lung disease, and acute lung injury
Consolidation
  • a parenchymal density with ill-defined bronchial and vascular margins
  • filling with infectious material [fluid, cells, tissue]
  • due to cellular exudates in alveoli
[[file
Crazy paving pattern
  • Septal thickening of inter and intra-lobar regions
  • with the background of the Ground glass opacity
  • Similar to paving stones
  • Due to alveolar edema and acute inflammation of the lung
  • Sign of progression


Reticuldar pattern
  • Linear opacities in the lungs
  • Due to Interstitial thickening of inter and intralobular septa
[[file
Air bronchogram
  • Air-filled bronchi
  • Low attenuated areas in the lung
[[file
Bronchiectasis
  • irreversible dilatation of the lung airways
  • Bronchus diameter more than 1.5 cm
  • due to inflammation, obstruction and impaired clearance
[[file