Question

1. List the causes of AKI?
2. Describe the management of acute kidney injury (AKI).
3. Identify the major indicators of chronic kidney failure (CKD).
4. Explain the differences between AKI and CKD
5. Explain the reasons for fluid retention of chronic kidney failure (CKD) and discuss the consequences of fluid retention.
6. Where and how do thiazide diuretics act in the kidneys

Answer 1

LIST OF CAUSES OF AKI:-

Most common casuse is sepsis (septic shock) which comes under ischemic causes. Broadly the causes can be classified into 4 types....

1. Ischemia causes- there may be reduce blood circulation volume( if hemorrhage, septic shock, loss of fluid in cases like dehydration, burns, diarrhoea,, heart failure) or , there may be intrarenal blood vessels involvement ( malignant hypertension, disseminated intravascular coagulation, )

2. Toxic injuries of the tubules ( also known as nephrotoxic cause)-- antibiotics like gentamycin, aminoglycosides leads to toxicity, NSAIDs(nonsteroidal antiinflammatory drugs) toxicity, heavy metal poisoning like lead, mercury, if radiation present.

3. If mismatched blood transfusion occured, skeletal muscle injury leads to kidney injury.

Hemolytic causes like sickle cell anemia,  

4. Urinary obstruction if present like tumors or hypertrophy of prostate present.

MANAGEMENT OF ACUTE KIDNEY INJURY:-

Firstly, correct the fluid imbalance( as there is dehydration, diarrhoea) by intravenous fluid administration. The electrolyte level should be corrected.

Control the potassium, calcium level in blood.. for potassium controlling use drugs like diuretics.

Dialysis should be done for removing the toxin from body as the body unable to quickly recovery from damage due to toxins.

Major indicators of chronic kidney failure:-

There should be persistent decreased of Glomerular filtration rate(GFR) less than 60 mL/min/1.73m² for last 3 months atleast. Should be present persistent albuminuria, increased serum creatinine level( more than 1.5 mg per dL).

Difference between AKI and CKD:-

1. The main difference is the onset.. AKI causes in acute as the name suggests. It should be happened just for few days or few weeks.. on the other hand CKD is for persistent kidney injury for atleast 3 months.

2. AKI is reversible .. CKD is irreversible. Means by using proper medication the AKI can be treated but The cure rate of CKD is much more less in comparison to AKI.

3. In AKI , there is rapid decline of GFR within hours .. In CKD there is persistent decline over a long periods .

4. retention of metabolic waste products occurs in AKI . In CKD there is not. In AKI there may be anuria or oliguria.