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AKI Definition
- AKI is defined as a creatinine increase of >0.3 in <48 hours, or a 50% increase from baseline.
- It can also be a urine output drop to <0.5 cc/kg/hour for six hours.
Assess Volume Status
- Thoroughly assess volume status, including history, exam, vital signs, and orthostatics, before ruling out prerenal azotemia.
- Don't assume the patient isn't dry without a proper assessment.
Prerenal Azotemia Nuances
- Prerenal azotemia isn't simply dehydration; it can be decreased effective circulating volume.
- Patients may be fluid overloaded yet have reduced kidney blood flow due to heart failure, cirrhosis, or pulmonary hypertension.