Hello and welcome to a new series of the Zero to Finals podcast.

My name is Tom and in this first episode I'm going to be talking to you about acute kidney injury.

And if you want to follow along with written notes on this topic, you can follow along at zero definals.com slash AKI

or in the renal section of the zero definals medicine book.

So let's get straight into it. An acute kidney injury or AKI is defined as an acute drop in kidney

function. And remember the kidneys are responsible for filtering the blood and getting rid of toxins and

excess fluid from the blood into the urine.

An acute kidney injury is diagnosed by measuring the serum creatinine.

And this is a waste product that's filtered by the kidneys into the urine.

The nice criteria for an A.K.I. are one of three things. A rising creatinine

of more than 25 micromoles per litre in 48 hours. A rising creatinine of more than 50% in 7 days.

Or a urine output of less than 0.5 mils per kilogram per hour for more than six hours.

So for example, if you had a 60 kilo lady and she was producing less than 30 mils of urine per

hour for more than 60 hours, that would be an acute kidney injury. So what the risk factors

for an acute kidney injury? You should think about and consider the possibility of an acute

kidney injury in patients that are suffering with an acute illness, such as an infection or having

recently had a surgical operation. The risk factors that would predispose you to developing an acute

kidney injury include chronic kidney disease already, so if they already have poor kidney function,

heart failure, diabetes, liver disease, older age, particularly people above 65 years old,

cognitive impairment, because maybe they're less likely to take fluid in.

Nephrotoxic medications such as non-steroidal anti-inflammatories,

like ibuprofen or neproxin, and ACE inhibitors, such as ramapril or licinopril.

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