Acute Kidney Injury: An Introduction Hussein Sheashaa, MD, FACP Professor of Nephrology, Urology and Nephrology Center and Director of Medical E-Learning Unit, Mansoura University, and Executive Director of ESNT- Virtual Academy: http://lms.mans.edu.eg/esnt/

Mortality in AKI Am J Med 2005;118:827–832.

Mortality in AKI Kidney International advance online publication , 1 May 2013; in Press

RIFLE

AKIN

AKI-KDIGO Guidelines 2.1.1: AKI is defined as any of the following (Not Graded): Increase in SCr by 0.3 mg/dL (26.5 mol/L) within 48 hours; or Increase in SCr to 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or Urine volume 0.5 mL/kg/h for 6 hours. Kidney Int Suppl. 2012;2:1-138.

AKIN and Mortality in Critically Ill Patients ( n= 1625 patients) Based on serum Cr Based on Urine output Nephrol Dial Transplant (2012) 27: 161–165

32,045 adult ICU patients J Am Soc Nephrol 2015;

Comprehensive textbook of Nephrology 2010 Presentation History and manifestations of the cause Oliguria or non-oliguria Edema, hypertension Uremic symptoms Manifestations of complications. Comprehensive textbook of Nephrology 2010

Symptoms Possible Diagnosis Presentation Symptoms Possible Diagnosis

Acute Kidney Injury: Role of Ultrasound Clin J Am Soc Nephrol 9: 382–394, Feb 2014.

Am J Kidney Dis. June 2014;63(6):

Clin J Am Soc Nephrol 9: 1132–1137, June 2014

AKI KDIGO Guidelines: Do not use Low dose dopamine (1A) Fenoldopam (1C) ANP (1C- IB) Rh-IGF-1 (IB) Nephrol Dial Transplant (2012) 0: 1–10

Clin J Am Soc Nephrol 10: 21–28, 2015

Cardiorenal Syndrome

Example from a 1915 Death Certificate from Massachusetts Example from a 1915 Death Certificate from Massachusetts. From Rudy’s List of Archaic Medical Terms at ttp://www.antiquusmorbus.com/English/Heart Stroke.htm

Dialytic Support

“You can't prevent what you can't predict.” K.M. Mac Aulay