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Acute Kidney Injury (Intrarenal (Blood Vessel (TTP, Eclampsia, Malignant…
Acute Kidney Injury
Intrarenal
Tubules
Acute Tubule necrosis
Toxin Mediated
Endogenous
Myoglobin (rhabdo)
Uric acid (tumor lysis)
LC (myeloma)
Hemoglobin (heme lysis)
Exogenous
ABX
Chemo
Ischemia Mediated
Muddy brown casts
Phases
Initiation phase
Maintenance
Recovery
Glomerulus
Acute glomerulonephritis
Sub nephrotic proteinuria
WBC/RBC casts
biopsy for dx
Types
PSGN
Lupus nephritis
ANCA Vasculitis
Anti GBM
IgA/HSP
Interstitum
Acute interstitial nephritis
Triad
Fever
Rash
Eosinophilia
Biopsy for DX
Etiology
Medication
Infxn
autoimmune
Reversible once underlying cause is treated
Blood Vessel
TTP
Eclampsia
Malignant HTN
Scleroderma renal crisis
Collecting system
Pyelonephritis
Flank pain
Fever
WBC casts
Leukocyte esterase
Pre-Renal
Absolute DEC in ECV
Hemorrhage
Relative DEC in ECV
CHF
Liver cirrhosis
DEC in ECV/ No autoregulation
NSAIDs
ACE-Is
Vasconstriction occlusion
hypercalcemia
renal artery stenosis
Post Renal
Upper urinary tract obstruction
Nephroliathiasis
Calcium Oxalate
envelope/dumbell
not enough citrate
drink lemon juice!
hypercalceuria
primary hyperparathyroidism
sarcoidosis
ethylene glycol
hyperoxaluria
vitamin c abuse
Calcium Phosphate
Wedge shaped
Form in alkaline urine
Uric Acid
RaduilUcent rhomboid
Obesity is risk
Hot/arid climates
Give potassium citrate
Struvite
Coffin lid
Staghorn
Alkaline urine
Proteus/ Klebsiella
Cystine
Radiolucent
Hexagonal
Staghorm
Malignancy
Lower urinary tract obstruction
Mainly prostatic disease
laser away BPH to relieve
Malignancy