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Acute Kidney Injury

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Handbook of Outpatient Medicine

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Abstract

Acute kidney injury (AKI) is defined as the deterioration in kidney function, detected by an increase in serum creatinine and decrease in glomerular filtration rate (GFR). Different classification systems exist for the diagnosis of AKI. Urine output can be variable, ranging from normal to anuria. AKI is classified into prerenal, intrinsic renal, and postrenal depending on the etiology. Common causes of AKI include volume depletion, acute tubular necrosis, acute interstitial nephritis (AIN), and urinary obstruction. A thorough history, review of medications, and physical examination are essential to sort out the etiology of AKI. Assessment of the patient’s volume status is crucial. Initial laboratory work-up includes blood testing and evaluation of urinalysis and urine sediment. A renal ultrasound is indicated in patients with AKI and suspicion for urinary obstruction. Treatment of AKI is directed toward correcting the underlying etiology and providing supportive measures. Careful monitoring should be undertaken for indications that would prompt initiation of dialysis, such as refractory electrolyte and acid base disturbances, refractory volume overload, uremic encephalopathy, and uremic pericarditis.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, Boardman Building 114, 330 Cedar Street, PO Box 208029, New Haven, CT, 06520-8029, USA

    Valerie Jorge Cabrera MD

Authors
  1. Valerie Jorge Cabrera MD
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Correspondence to Valerie Jorge Cabrera MD .

Editor information

Editors and Affiliations

  1. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Elana Sydney

  2. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Eleanor Weinstein

  3. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Lisa M. Rucker

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Cabrera, V.J. (2018). Acute Kidney Injury. In: Sydney, E., Weinstein, E., Rucker, L. (eds) Handbook of Outpatient Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-68379-9_29

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  • DOI: https://doi.org/10.1007/978-3-319-68379-9_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68378-2

  • Online ISBN: 978-3-319-68379-9

  • eBook Packages: MedicineMedicine (R0)

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