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Related Concept Videos

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

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

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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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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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 V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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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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White paper on mitigating risk factors for acute kidney injury in TAVR: A protocol to decrease TAVR-associated AKI.

Sohrab Singh1, Ashish Pershad2

  • 1The Brooklyn Hospital Center, Clinical and Academic Affiliate of Icahn School of Medicine at Mount Sinai, United States.

Indian Heart Journal
|April 21, 2023
PubMed
Summary

Acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR) is common and linked to poor outcomes. This paper outlines a clinical pathway to reduce AKI risk by managing modifiable factors like contrast volume.

Keywords:
AKITAVR

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Area of Science:

  • Cardiology
  • Nephrology
  • Healthcare Management

Background:

  • Acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR) is associated with adverse patient prognoses.
  • The incidence of AKI post-TAVR is approximately 10% in the TVT registry.
  • Multifactorial causes of AKI exist, with contrast volume identified as a key modifiable risk factor.

Purpose of the Study:

  • To address the unmet clinical need for a structured approach to mitigate AKI risk in TAVR patients.
  • To propose a comprehensive clinical pathway from TAVR referral to procedure completion.
  • To minimize the incidence and impact of contrast-induced nephropathy in TAVR candidates.

Main Methods:

  • Development of a multidisciplinary clinical pathway.
  • Integration of risk factor management, including contrast volume optimization.
  • Standardization of care protocols across multiple healthcare touchpoints.

Main Results:

  • The proposed pathway aims to reduce AKI incidence post-TAVR.
  • Implementation is expected to improve patient outcomes and reduce healthcare costs.
  • Focus on modifiable risk factors like contrast administration.

Conclusions:

  • A defined clinical pathway is crucial for managing AKI risk in TAVR.
  • Optimizing contrast volume and standardizing care can significantly lower AKI rates.
  • This pathway offers a proactive strategy to improve TAVR patient safety and outcomes.