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Medicine

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Kidney

Question
4 out of 15
 

As per Rifle criteria, for acute kidney injury urine production <0.5 ml/kg for 12 hours indicates? (PNQ)



A Risk

B Injury

C Failure

D End stage renal disuse

Ans. B Injury

Extra Edge:

ARF: (AKI – Acute Kidney Injury) (Ref. H-17th Edi, P- 1752)

Acute renal failure is defined as a sudden decrease in renal function resulting in the retention of urea nitrogen and creatinine in the blood.

Staging

The RIFLE criteria, for the staging of patients with AKI:

i. Risk: serum creatinine increased 1.5 times or urine production of <0.5 ml/kg for 6 hours

ii. Injury: doubling of creatinine or urine production <0.5 ml/kg for 12 hours

iii. Failure: tripling of creatinine or creatinine (>4 mg/dl) OR urine output below 0.3 ml/kg for 24 hours

iv. Loss: persistent AKI or complete loss of kidney function for more than 4 weeks

v. End-stage renal disease:complete loss of kidney function for more than 3 months

Note: RIFLE criteria is given in 17th edition but it is not there in 18th edition !!!.

Symptoms and Signs :

Patient may have features of uremia (Nausea, Vomiting, Diarrhea, Dyspnea & Oliguria)

Urinalysis shows an active urinary sediment, with renal tubular epithelial cells, cellular debris, pigmented granular casts, renal tubular cell casts, and “muddy brown” Qcoarse granular casts.

Controversy about Definition of Oliguria & anuria

A. Oliguria has been defined in different ways in Harrison 17thed/ 18thed / Baily & Love (25thedi, Pg- 1279)

B. In Harrison 17th edition oliguria has been defined as urine output less 500 ml /day (Page 271), in 17theditself it is defined as urine output less than 400ml/day(Page 1752) but in 18th edition oliguria defined in urine output 400 ml/day. (Harrison-18th edition, Pg – 338)!!!

C. In Harrison 15th edition (Pg-265) oliguria i.e. urine output less than 500 ml/day &anuria is complete absence of urine formation.

D. In Harrison 12th edition (Pg 273, 1146) oliguria is urine output less than 400 ml/day and anuria is complete absence of urine formation.

E. In Baily & Love(25thedi, Pg- 1279) oliguria has been defined as urine output less than 300 ml/day!!!.

F. In Harrison 17th edition anuria has been defined as urine output less than 50ml/day (Pg 271)

G. In Harrison 18th edition anuria has been defined as urine output less than 100ml/day (Pg 338)

H. In Baily & Love (25thedi, Pg- 1279) anuria has been defined as complete absence of urine formation !!!.

Kidney Flashcard List

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