ACUTE KIDNEY INJURY (AKI)-POST RENAL AKI

SUMMARY

1. Obstruction beyond the bladder usually not associated with acute renal failure unless: pre-existing renal disease or solitary functioning kidney.
2. Most people who obstruct 1 kidney still have a remaining normal kidney, eGFR minimally affected in these cases.

INX
3. Renal US may show hydronephrosis.

MANAGEMENT
4. Relieve the obstruction: nrology opinion frequently required, nephrology intervention infrequently required.
5. Dialysis rarely prior to alleviation of obstruction.

COMPLICATIONS
6. Monitoring for post-obstructive diuresis: massive urine output predisposing to dehydration (pre-renal failure) & electrolyte abnormalities (most often hypokalaemia).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].