"improving intensive care in Scotland"

Acute Kidney Injury Part 1:

Additional activities

 

  • Scrutinise the notes, drug charts and review the history.
  • Fully examine the patient.
  • Look for infection and treat it.
  • Examine the urine: proteinuria and haematuria may indicate glomerulonephritis and urgent renal referral is obligatory. Look for skin rash, nail changes, arthralgia and history of rigors.
  • Early diagnosis and appropriate treatment such as immunosuppression/plasma exchange may save renal function therefore always consider early discussion with the renal team. GN bloods include anti-nuclear factor, anti neutrophil cytoplasmic antibody, anti-glomerular basement membrane antibody, rheumatoid factor.
  • Fluid balance: once volume depletion corrected, and in the absence of fluid overload, give previous hour’s output (urine and other losses) plus insensible (about 20-40ml/hr).

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