genitourinary disorders
Acute Kidney Injury (AKI)
Symptoms and Signs of AKI
Initially, weight gain and peripheral edema may be the only findings. Often, predominant symptoms are those of the underlying illness or those caused by the surgical complication that precipitated renal deterioration. Symptoms of uremiamay develop later as nitrogenous products accumulate. Such symptoms include Anorexia Nausea Vomiting Weakness Myoclonic jerks Seizures Confusion Coma Asterixis and hyperreflexia may be present on examination. Chest pain (typically worse with inspiration or when recumbent), a pericardial friction rub, and findings of pericardial tamponade may occur if uremic pericarditis is present. Fluid accumulation in the lungs may cause dyspnea and crackles on auscultation. Other findings depend on the cause. Urine may be cola-colored in Overview of Nephritic Syndrome or myoglobinuria. A palpable bladder may be present with outlet obstruction. The costovertebral angle may be tender if the kidney is acutely enlarged. Amount of urine output during acute kidney injury (AKI) does not clearly differentiate between prerenal, renal, or postrenal causes. In acute tubular injury, urine output may have 3 phases: Theprodromal phaseusually has normal urine output and varies in duration depending on causative factors (eg, the amount of toxin ingested, the duration and severity of hypotension). Theoliguric phasehas urine output typically between 50 and 500 mL/day. The duration of the oliguric phase is unpredictable, depending on etiology of AKI and time to treatment. However, many patients are never oliguric. Nonoliguric patients have lower mortality and morbidity and less need for dialysis. levels may not fall for several more days. Tubular dysfunction may persist for a few days or weeks and is manifested by sodium wasting, Polyuria (possibly massive) unresponsive to 