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UROLOGY / NEPHROLOGY - AKI, ATN (*AKI defined by 2 things -->…

- - - - *Causes of AKI and classification
        
        PRE INTRA and POST renal AKI
        
        POST renal AKI
        
        PRE renal AKI
        
        INTRArenal AKI
        
        1 more item...
      - *BUN/Creatinine ratio
        
        PRE AKI = Raised BUN/Creatinine >20:1
        --> note creatinine NOT raised
        
        INTRA AKI = Raised BUN/Creatinine < 10:1
        --> half of PRE AKI
        --> since the kidney is damaged itself so can't actually absorb that well
        
        POST AKI
        --> starts midway between PRE and INTRA = BUN creatinine ratio = 15:1
        --> moves to INTRA renal as the stone/BPH blockage moves back into the kidney and causes damage
        
        PHYS
        
        note the BUN/creatinine ratio measures two things for the kidney function
        
        BUN
        
        measures the ability of kidney to concentrate urine with Blood urea nitrate
        
        Creatinine
        
        recall that creatinine clearance estimates GFR and PAH estimates RPF
  - - - PAthophys of AKI
        - "MAD HUNGER"
        
        AKI MAD HUNGER = Uremia - high ADH response
        
        from response of increased BUN and urea reabsorption
        
        AKI MAD HUNGER = Hyperkalemia
        --> lose ROMK channels that leak K+ into the lumen at CD
        (ROMK and ENaC (aldosterONE Na+) work in opposite directions at the CD)