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Related Concept Videos

Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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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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Nephrotic Syndrome I : Introduction01:24

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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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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Acute Kidney Injury I: Introduction01:22

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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 III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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 VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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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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Related Experiment Video

Updated: Dec 22, 2025

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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Osmotic Nephrosis and Acute Kidney Injury Associated With SGLT2 Inhibitor Use: A Case Report.

Gautam Phadke1, Amit Kaushal1, Dean R Tolan2

  • 1Sanford Health, University of North Dakota School of Medicine, Fargo, ND.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 11, 2020
PubMed
Summary

A patient developed severe acute kidney injury (AKI) requiring dialysis after starting canagliflozin. Kidney biopsy revealed osmotic nephropathy, suggesting a link between SGLT2 inhibitors and this complication.

Keywords:
Acute renal failure (ARF)SGLT2 inhibitorsacute kidney injury (AKI)canagliflozincase reporthemodialysiskidney biopsyosmotic nephropathysodium/glucose cotransporter 2 (SGLT2)

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Canagliflozin, a sodium/glucose cotransporter 2 (SGLT2) inhibitor, is used for type 2 diabetes.
  • Acute kidney injury (AKI) is a potential adverse effect of SGLT2 inhibitors.

Observation:

  • A 66-year-old male with type 2 diabetes developed oliguric AKI 5 days after initiating canagliflozin.
  • The patient presented with hematuria, proteinuria, and elevated creatinine, requiring hemodialysis.
  • Acute interstitial nephritis was considered due to recent antibiotic use.

Findings:

  • Kidney biopsy confirmed osmotic nephropathy as the cause of AKI.
  • Kidney function returned to baseline after 2 weeks of hemodialysis.
  • This case suggests an association between canagliflozin use and osmotic nephropathy.

Implications:

  • Severe AKI in patients on SGLT2 inhibitors may be linked to osmotic nephropathy.
  • Kidney biopsy is recommended for severe AKI associated with SGLT2 inhibitors to elucidate the relationship.
  • Further research into the mechanisms of SGLT2 inhibitor-associated nephrotoxicity is warranted.