Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-22T22:20:50.508Z Has data issue: false hasContentIssue false

46 - Acute kidney injury and emergent dialysis

from Section 7 - Renal emergencies

Published online by Cambridge University Press:  05 November 2013

Kaushal Shah
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
Jarone Lee
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston
Kamal Medlej
Affiliation:
American University of Beirut
Scott D. Weingart
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
Get access

Summary

This chapter discusses the diagnosis, evaluation and management of acute kidney injury (AKI). It describes special circumstances for diagnosis and management of acute interstitial nephritis, contrast-induced nephropathy and rhabdomyolysis. A careful patient history frequently reveals etiology of renal failure (e.g., medications or recent administration of contrast dye). A careful patient history and appropriate laboratory testing should reveal the cause of AKI. Once AKI is diagnosed, all drugs that cause renal injury should be discontinued. Volume overload due to AKI can lead to pulmonary edema, which may require respiratory support including noninvasive positive-pressure ventilation or intubation. Patients with AKI who suddenly decompensate should be rapidly evaluated for electrolyte imbalances. Hyperkalemia, which can cause cardiac arrhythmias, is the most concerning. AKI resulting in metabolic acidosis can cause hypotension. Temporary treatment includes volume resuscitation and vasopressors. A sodium bicarbonate infusion can be considered while preparing for dialysis.
Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×