AKI or acute renal failure

https://www.thinkkidneys.nhs.uk/aki/think-kidney-publications/

3 types:

  1. Prerenal azotemia (decreased perfusion)
  2. Postrenal azotemia (obstruction)
  3. Intrinsic renal disease (ischemia or toxins)
Pre-renal uraemia ('azotemia') Acute tubular necrosis
Urine sodium < 20 mmol/L
Urine osmolality > 500 mOsm/kg
Fractional sodium excretion* < 1%
Response to fluid challenge Good
Serum urea:creatinine ratio Raised
Fractional urea excretion** < 35%
Urine:plasma osmolality > 1.5
Urine:plasma urea > 10:1
Specific gravity > 1020
Urine Normal/ 'bland' sediment

Prerenal uraemia - kidneys hold on to sodium to preserve volume

AKI secondary to atheroemboli

Cholesterol plaques in the aorta or near the coronary arteries can dislodge after manipulation/ catheter procedures, causing cholesterol emboli lodge in the kidney and then AKI.

Presents with blue/purplish skin lesions in fingers and toes, livedo reticularis, and ocular lesions

Dx