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Acute Kidney Injury

5 bytes removed, 20:11, 16 December 2023
Mechanism of Acute Kidney Injury
Post-renal failure or obstructive renal failure are caused by disease states downstream of the kidneys resulting in extrarenal obstruction of urinary flow.<ref name = "Ref20">Raup, V.T., Chang, S.L. and Eswara, J.R. (2018) ‘Post-renal acute kidney injury: Epidemiology, presentation, pathophysiology, diagnosis, and management’, Core Concepts in Acute Kidney Injury, pp. 247–256. doi:10.1007/978-1-4939-8628-6_16.
</ref> These can be related to neurogenic bladder conditions, obstructed urinary catheters, bladder stones, or cancers of the bladder, prostate or ureter. <ref name = "Ref20"/>
The GFR in mL/min can be calculated with the following formula: '''GFR''' = ( U<sub>X</sub> · V̇ ) / P<sub>X</sub>. Here, U<sub>X</sub> and P<sub>X</sub> are the concentrations of substance X in urine and plasma in mg/mL respectively, with V̇ being the urine flow in mL/min. Ideally X is a substance that is freely filtered but not secreted or reabsorbed by the kidneys, subsequently having the same concentration in the plasma and glomerular filtrate. <ref name = "Ref21">Pocock, G., Richards, C.D. and Richards, D.A. (2013) Human physiology. Oxford: Oxford University Press.</ref>These criteria are largely met by creatinine, and the creatinine clearance (C<sub>Cr</sub>) obtained from this formula is generally used to measure GFR in clinical practice. <ref name = "Ref22">Delgado, C. et al. (2022) ‘A unifying approach for GFR estimation: Recommendations of the NKF-ASN task force on reassessing the inclusion of race in diagnosing kidney disease’, American Journal of Kidney Diseases, 79(2). doi:10.1053/j.ajkd.2021.08.003.</ref> Other diagnostic tools also include serum creatinine levels (SCr) as in the case of renal dysfunction, the creatinine clearance by the kidneys is reduced and therefore the creatinine concentration in the blood rises . <ref name = "Ref21"/>
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