clinical assessment of acute kidney injury

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Clinical assessment:

History and examination

  • clinical assessment of the patient with acute kidney injury (AKI) starts with a comprehensive history including a review of:
    • patient notes

    • AKI risk factors
      • age > 75 yrs
      • chronic kidney disease (CKD, eGFR < 60 mls/min/1.73m2)
      • Cardiac failure
      • Atherosclerotic peripheral vascular disease
      • Liver disease
      • Diabetes mellitus
      • Nephrotoxic medications

    • potential causes for AKI including
      • reduced fluid intake
      • increased fluid losses
      • urinary tract symptoms
      • recent drug ingestion
      • sepsis

    • systemic clinical features
      • fever
      • rash
      • joint pains

Clinical examination must include:

  • general
    • rash
    • uveitis
    • joint swelling

  • assessment of volume status
    • core temperature
    • peripheral perfusion
    • heart rate
    • blood pressure
    • jugular venous pressure

  • signs of renovascular disease
    • audible bruits
    • impalpable peripheral pulses

  • abdominal examination
    • palpable bladder

Reference:

Last reviewed 01/2018

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