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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Paige Garber Bradshaw, Pharm.D., BCCCP UC Health - University of Cincinnati Medical Center James L. Winkle College of…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Paige Garber Bradshaw, Pharm.D., BCC…

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Learning Objectives 3 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Learning Objectives 1. Define acute kidney injury (AKI). 2. Differentiate between common categories of drug- induced…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient 5. Which drug would most likely be cleared through a CVVHD circuit? A. Drug A: 10% protein bound, 140-Da molecular…

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Exam Content Outline 1 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient BPS Critical Care Pharmacy Examination Content Outline This chapter covers the following sections of the Critical Care…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient I.  ACUTE KIDNEY INJURY A. Introduction 1. Acute kidney injury (AKI), previously known as acute renal failure, is an…

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Data Tables 4 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient b. The primary difference between the RIFLE and the AKIN criteria is that AKIN includes a small absolute change in SC…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient RIFLE AKIN KDIGO All Three Classification Systems Stage SCr/GFR Criteria Stage SCr Criteria Stage SCr Criteria UOP Cr…

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Data Tables 3 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Table 2. KDIGO’s Definitions of NKD, AKI, AKD, and CKD According to Function and Structure Functional Criteria (change…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient 10. Biomarkers: Recently, significant advances were made in the field of biomarkers for predicting and detecting AKI…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient (c) A retrospective cohort study of the ProCESS trial by the ProGReSS-AKI investigators (JAMA Netw Open 2022:5:e22127…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient F. Drug-Induced Kidney Disease (DIKD) 1. Drugs are associated with about one-third of AKI cases in the hospital. The…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient 5. Intrarenal toxicity: There are several types of kidney toxicity from xenobiotics. These include direct tubular tox…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient i. Examples of drugs that contribute to immune-mediated glomerular diseases include hydralazine and propylthiouracil.…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Patient Case Questions 1–3 pertain to the following case. F.B. is a 68-year-old male patient (weight 70 kg) admitted to…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient 5. Historically, KRT has been offered when a patient fulfills at least one of the AEIOUs: severe Acidosis, Electrolyt…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient C. Intermittent Hemodialysis (IHD) 1. IHD is the most common form of KRT used in the acute setting for treating patie…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient E. Prolonged Intermittent KRT 1. Sustained low-efficiency dialysis (SLED), sustained low-efficiency daily diafiltrati…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient b. Solutes are considered to have a small MW (less than 1000 Da), middle MW (1000-30,000 Da), or large MW (greater th…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient ii. Small substances (e.g., urea with an MW of 60 Da) are cleared more rapidly than larger substances (e.g., drugs wi…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Patient Case Questions 4–6 pertain to the previous case. F.B. is a 68-year-old man (weight 70 kg) admitted to your ICU…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient REFERENCES Acute Kidney Injury Bairy M. Using kinetic eGFR for drug dosing in AKI: concordance between kinetic eGFR, C…

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Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient Silver SA, Adhikari NK, Bell CM, et al. Nephrologist follow-up versus usual care after an acute kidney injury hospita…

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Answers & Explanations 4 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient ANSWERS AND EXPLANATIONS TO PATIENT CASES 1. Answer: C Both RIFLE class “F” and AKIN stage 3 are met using similar SC…

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Self-Assessment 3 min

Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient ANSWERS AND EXPLANATIONS TO SELF-ASSESSMENT QUESTIONS 1. Answer: A The drug-induced kidney disease phenotype most like…

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