Acute Kidney Injuries Discussion Question Paper

Acute Kidney Injuries Discussion Question Paper

Acute Kidney Injuries Discussion Question Paper

DQ Question
Acute renal insufficiency is characterized by poor function of the kidneys, often caused by a decrease in blood flow to the kidneys caused by renal artery disease. Patients have reduced kidney function. When kidney decline is sudden, the functioning nephrons are overworked, and kidney dysfunction may develop with the loss of only 50% of functioning nephrons (Lušija et al., 2022). Renal insufficiency is associated with Aging, Genetic factors, hyperlipidemia, hypertension, smoking, diabetes, and obesity. The definitive diagnostic test for acute renal insufficiency is contrast angiography. Other tests include duplex ultrasound scanning, CT angiography, and MR angiography.

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AKI is a clinical syndrome characterized by rapid loss of renal function with progressive azotemia (an increase of nitrogenous wastes such as BUN and creatinine). AKI is classified into prerenal, renal, and postrenal. Prerenal AKI is caused by inadequate renal perfusion. Renal causes of AKI involve intrinsic kidney disease or damage. Postrenal AKI is caused by various types of obstruction in the voiding and collecting parts of the urinary system (Gameiro et al., 2020). Diagnostic tests include Serum creatinine and BUN levels, Urinalysis, Renal ultrasound, CT scan, or MRI. Treatment includes correction of pulmonary edema and hyperkalemia. Medications include diuretics and Calcium channel blockers.
Question 2
CKD is characterized by the progressive, irreversible loss of kidney function. Kidney damage or GFR less than 60ml/hr for three months or longer is present. It has five stages. Stage 1 is kidney damage with normal or increased GFR with GFR ≥ 90ml/min. Stage 2 is kidney damage with a mild reduction in GFR 60-89ml/min. Stage 3 is a moderate reduction in 30-59ml/min. Stage 4 is a severe reduction in GFR 15-29ml/min. Stage 5, end-stage renal disease (ESRD), is characterized by kidney failure with GFR ˂1ml/min (Chen et al., 2019). Diagnostic tests include Urinalysis, BUN, UECs, Serum creatinine values, estimated GFR, and imaging of kidneys through ultrasound and CT scan. Treatment includes correction of hyperkalemia and antihypertensive. Drug doses should be adjusted to the degree of renal function. Nutrition therapy includes Protein, water, sodium, potassium, and phosphate restriction.
Dialysis is indicated in ESRD and severe hyperkalemia. In intermittent hemodialysis, solute clearance occurs primarily by diffusion, while ultrafiltration removes volume. CRRT modalities use diffusion, convection, or a combination of both for solute clearance (Fathima et al., 2019). In peritoneal dialysis, the peritoneum is used as a semi-permeable membrane for diffusive removal of solutes
References
Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic Kidney Disease Diagnosis and Management: A Review. JAMA, 322(13), 1294–1304. https://doi.org/10.1001/jama.2019.14745
Fathima, N., Kashif, T., Janapala, R. N., Jayaraj, J. S., & Qaseem, A. (2019). Single-best Choice Between Intermittent Versus Continuous Renal Replacement Therapy: A Review. Cureus, 11(9), e5558. https://doi.org/10.7759/cureus.5558
Gameiro, J., Fonseca, J. A., Outerelo, C., & Lopes, J. A. (2020). Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies. Journal of clinical medicine, 9(6), 1704. https://doi.org/10.3390/jcm9061704
Lušija, S., Vuk, S., Salić, E., Ajanović, A., Katica-Mulalić, A., Bečić, E., & Halvadžić, E. (2022). Acute renal insufficiency in SARS-CoV-2-2019 patients. Medical Journal, 28.

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Answer both of the following questions. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

Differentiate acute renal insufficiency versus acute kidney injury (AKI). Explain the diagnosis, etiology, and treatment for both. Describe the types of AKI including prerenal, intrarenal, and postrenal etiologies. Include diagnostic criteria for each etiology.

Define chronic kidney disease, including stages, diagnosis, treatment, and prevention. Explain the indications for dialysis as well as the differences in the forms of dialysis (intermittent hemodialysis, CRRT, peritoneal dialysis).