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AKI Case

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Frederick was given a preliminary diagnosis of a prerenal AKI. AKI is a complex condition with various different definitions available, most including a rapid decline in kidney function and the lack of ability of the kidneys to filter blood, subsequently leading to increased levels of serum creatinine and BUN levels in the blood (Cheung et al., 2008). AKI is the leading cause of nephrology consultation in the UK and carries with it high mortality rates (Basile, 2012). The primary causes of an AKI are hypoxia, ischemia and nephrotoxicity. The main underlying feature of an AKI is a rapid decrease in the glomerular filtration rate (GFR), which is strongly linked with a decrease in blood flow to the kidneys. The GFR depends on the interplay between …show more content…

It is secondary to under-perfusion of otherwise normally functioning kidneys and if detected early can be reversible. In Mr Jones’s case, his kidney’s experienced hypo-perfusion during surgery. Hypo-perfusion consequently causes azotemia due to the excess nitrogenous wastes in the blood. Medications, such as high doses of dopamine, can cause prerenal kidney injury due to the production of intrarenal vasoconstriction, which can lead to hypo perfusion of the glomeruli (Nissenson, 1998). The kidneys have an enormous blood supply and account for 20-25% of cardiac output. This blood supply is needed for the removal of waste products and the management of fluid and electrolyte balances. If the blood flow to the kidneys is reduced, this has a decreasing effect on the GFR leading to a decreased urine output, filtration and reabsorption of filtered material through the glomerulus. This can lead to further issues and effect other organs in the body. Fredrick experienced a decreased urine output as a symptom of his reduced GFR. Fredrick’s increased respiration rate noted during assessment was an indicator of his deterioration and alerted the medical team that there was an underlying issue. During the nurse’s assessment, they observed that Frederic had very poor urine output, which is also linked with the drop in the GFR in the kidneys. Thus, encouraging the nursing staff to take immediate action with thereputic

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