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Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Acute Kidney Injury II: Pathophysiology01:29

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Acute Kidney Injury V: Interprofessional Care01:20

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
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Acute toxic kidney injury.

Nadezda Petejova1,2,3, Arnost Martinek1,2, Josef Zadrazil3

  • 1a Department of Internal Medicine , University Hospital Ostrava , Ostrava , Czech Republic.

Renal Failure
|June 26, 2019
PubMed
Summary

Numerous nephrotoxic substances cause acute kidney injury (AKI) through various pathways. This review covers toxins from medications, plants, animals, chemicals, and illicit drugs, alongside diagnosis and management strategies for toxic AKI.

Keywords:
acute kidney injurydrug nephrotoxicityillicit drug nephrotoxicityplant nehrotoxicityrenal biomarkerstoxic nephropathy

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Area of Science:

  • Nephrology
  • Toxicology
  • Internal Medicine

Background:

  • The kidney's unique physiology makes it susceptible to injury from a wide array of nephrotoxic agents.
  • Acute kidney injury (AKI) from toxic substances is a significant global health challenge, with varied epidemiology.
  • Understanding the diverse sources and mechanisms of nephrotoxicity is crucial for effective management.

Purpose of the Study:

  • To review the spectrum of nephrotoxic insults encountered in clinical practice.
  • To consolidate information on diverse nephrotoxic agents, including medications, natural toxins, and environmental chemicals.
  • To provide an overview of the diagnosis, clinical presentation, and management of poisoning-induced AKI.

Main Methods:

  • Comprehensive literature review focusing on nephrotoxic substances and their impact on kidney function.
  • Categorization of nephrotoxic agents by source: medications, plants, animal venoms, environmental chemicals, and illicit drugs.
  • Synthesis of information on pathophysiological pathways, clinical manifestations, and therapeutic interventions.

Main Results:

  • A wide range of substances, including common medications, plant-derived toxins, animal venoms, agricultural chemicals, and illicit drugs, can induce AKI.
  • Nephrotoxicity occurs via diverse mechanisms, often exacerbated by drug interactions and individual patient factors.
  • Toxic AKI presents with varied clinical signs and often involves dysfunction of other organs.

Conclusions:

  • Nephrotoxic AKI is a complex clinical problem requiring a broad understanding of potential causative agents.
  • Early diagnosis and prompt management are essential for improving outcomes in patients with toxic AKI.
  • Further research into the mechanisms and treatment of toxic AKI is warranted to mitigate its impact.