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Types of Acute Kidney Injury & Linked Clinical manifestations
Mr. J.R., 73, has symptoms consistent with gastroenteritis and may have renal injury as well. Acute kidney injury (AKI) is described as a rapid decline in kidney function and is classified into prerenal, intrarenal, and postrenal stages. Mr. J.R.’s clinical symptoms are consistent with this type of AKI.
Reduced renal blood flow is a common cause of prerenal acute kidney injury. Mr. J.R.’s adequate circulating volume dropped because of his dehydration from vomiting and diarrhea. Dehydration and hypovolemia are described as significant risk factors for prerenal acute kidney injury (AKI) by Siew et al. (2019).
Inflammation and toxins from gastroenteritis can damage the renal tubules and glomeruli, causing intrarenal acute kidney injury. Weakness and a metallic taste in the mouth are just some of the symptoms of AKI due to acute tubular necrosis (ATN), as described by Hoste et al. (2018). Obstruction of the urinary tract is a common cause of postrenal acute kidney injury. Since Mr. J.R. did not exhibit symptoms of urinary obstruction, this type of AKI is less likely.
Due to several risk factors, Mr. J.R. has a higher-than-average risk for AKI. As Coca & Singanamala (2017) observed, J.R.’s advanced age is another significant risk factor for AKI. They found that both the frequency and severity of AKI increase with age. As a person ages, their kidneys become weaker and more easily damaged.
Kellum & Lameire (2018) point out that low blood volume in the kidneys due to dehydration can trigger AKI, making J.R.’s emesis and diarrhea a risk factor for the development of acute kidney injury. Pianta et al. (2019) discuss the connection between infectious gastroenteritis and acute kidney injury (AKI), which J.R. likely caught from the fast food restaurant. As stated by Charney & Parsonnet (2020), the bismuth contained in Mr. J.R.’s Pepto-Bismol use poses a risk because it can accumulate in the renal tubules, contributing to an increased risk of AKI for him.
Hematologic System Complications and Pathophysiologic Mechanisms
Hematologic system complications, such as coagulopathy and anemia, may arise if Mr. J.R.’s kidney damage progresses to CKD. Coagulopathy and anemia are common complications of chronic kidney disease (CKD) that have their origins in the pathophysiology of kidney dysfunction.
Procoagulant and anticoagulant factors in the blood are thrown out of whack by CKD. According to Sarode & Kanjwal (2019), uremic toxins in CKD can affect platelet function and clotting factors, leading to coagulopathy and increasing the risk of bleeding, especially in the gastrointestinal tract.
Reduced erythropoietin production is a common cause of anemia in people with CKD. Coresh et al. (2019) explain that a lack of erythropoietin can cause anemia because it stimulates the body to produce more red blood cells. Anemia is a common symptom of CKD, which explains Mr. J.R.’s weakness and fatigue.
In conclusion, J.R.’s case demonstrates the potential of AKI with identifiable clinical presentation. The patient’s age, dehydration, gastroenteritis, and medication use all pose potential threats to his health. Hematologic complications, such as coagulopathy and anemia, may arise if his kidney damage progresses to the point where he is diagnosed with CKD. Managing AKI and preventing its progression to CKD through early diagnosis and intervention is vital in improving the patient’s overall prognosis.