genitourinary disorders
Acute Kidney Injury (AKI)
Key Points
Causes of AKI can be prerenal (eg, kidney hypoperfusion), renal (eg, direct effects on the kidney), or postrenal (eg, urinary tract obstruction distal to the kidneys). With AKI, consider ECF volume depletion and nephrotoxins, obtain urinary diagnostic indices and measure bladder residual volume to identify obstruction. Avoid or minimize use of iodinated IV contrast in imaging studies. Initiate hemodialysis or hemofiltration as needed for pulmonary edema, hyperkalemia, metabolic acidosis, or uremic symptoms unresponsive to other treatments. Minimize risk of AKI in patients at risk by maintaining normal fluid balance, avoiding nephrotoxins (including iodinated intravenous contrast agents) when possible, and taking precautions such as giving fluids or drugs when contrast or cytolytic therapy is necessary. 