Lesson 1Urine studies and interpretation: urinalysis, urine sediment microscopy, urine electrolytes, fractional excretion of sodium and ureaThis part explains how to collect and read urine tests in AKI on CKD, covering urinalysis, looking at urine sediment under microscope, urine electrolytes, and calculations like fractional excretion to tell apart causes before the kidney, in the kidney, or after the kidney.
Standard urinalysis and dipstick findingsSediment microscopy and key castsUrine sodium and osmolality patternsFENa, FEUrea, and their limitationsIntegrating urine data with clinical contextLesson 2Acute complications requiring urgent action: hyperkalemia, severe acidosis, pulmonary edema, uremic manifestationsThis part deals with urgent problems from AKI on CKD like high potassium, bad acidosis, fluid in lungs, and signs of waste buildup, focusing on quick stabilisation and when to start emergency dialysis.
Emergency management of hyperkalemiaTreatment of severe metabolic acidosisRecognition and therapy of pulmonary edemaIdentifying uremic symptoms and signsDialysis triggers in acute complicationsLesson 3Definitions and staging of AKI and CKD, KDIGO criteria and integrationThis part goes over what AKI and CKD mean, how to stage them using KDIGO rules, combining acute and long-term changes, and how this helps predict outcomes, watch closely, and know when to call a specialist.
KDIGO AKI diagnostic criteriaKDIGO AKI staging and prognosisCKD definition, staging, and GFR categoriesIntegrating AKI on CKD classificationsImplications for follow-up and counselingLesson 4Pathophysiology of acute on chronic kidney injury: hemodynamic, intrinsic, and postrenal causesThis part looks at how acute injury on chronic kidney problems happens, separating blood flow issues, damage inside the kidney, and blockages after, linking to patient signs, tests, and treatments.
Hemodynamic causes and renal perfusionIntrinsic tubular and glomerular injuryPostrenal obstruction mechanismsNeurohormonal activation in CKD and AKIPathophysiology–guided treatment choicesLesson 5Identification and management of reversible precipitants: sepsis, nephrotoxins, volume depletion or overload, obstructionThis part covers spotting and fixing things that can be reversed causing AKI in CKD patients, like infections in blood, kidney poisons, low fluids or too much, and blockages, aiming for fast fixes to stop more damage.
Recognizing sepsis and hemodynamic instabilityIdentifying and stopping nephrotoxic medicationsAssessing hypovolemia and fluid responsivenessManaging volume overload and decongestionDetecting and relieving urinary tract obstructionLesson 6Imaging indications and interpretation: renal ultrasound for obstruction, bladder scan, point-of-care ultrasound for volume statusThis part teaches when and how to use scans for AKI on CKD, like kidney ultrasound for blockages, bladder checks for holding urine, and quick bedside scans for fluid levels, heart work, and lung fluid.
Indications for renal ultrasoundRecognizing hydronephrosis and obstructionBladder scan for retention and retention riskPOCUS for IVC and volume assessmentLung and cardiac POCUS in AKI on CKDLesson 7Key laboratory interpretation: creatinine kinetics, BUN/creatinine ratio, electrolytes, acid-base analysis, lactateThis part focuses on reading main blood tests in AKI on CKD, like how creatinine changes, BUN to creatinine ratio, salts, acid balance, and lactate levels to separate new from old problems and guide urgent care.
Creatinine trends and baseline estimationUsing BUN/creatinine ratio in contextElectrolyte patterns in AKI on CKDAcid–base analysis and anion gap useLactate, perfusion, and tissue hypoxiaLesson 8Decision-making for renal replacement therapy in AKI: indications, timing, modality selection (intermittent hemodialysis vs CRRT vs SLED)This part discusses choices for dialysis in AKI on CKD, standard reasons, when to start, and picking between short dialysis sessions, continuous replacement, or slower extended dialysis based on patient stability, available equipment, and care aims.
Absolute and relative indications for RRTEarly versus delayed initiation strategiesChoosing intermittent HD versus CRRTWhen to use SLED and hybrid approachesAnticoagulation and access considerationsLesson 9Interdisciplinary communication with ICU, ED, primary teams and nursing for urgent AKI careThis part stresses good teamwork talk between intensive care, emergency, main doctors, and nurses for urgent AKI care, using shared understanding, clear job sharing, warning signs, and standard handovers for better safety.
Essential data to share during handoffClarifying roles and responsibilitiesEscalation criteria and rapid responseCommunicating dialysis urgency and plansDocumentation and closed-loop communicationLesson 10Initial rapid bedside assessment: history, focused exam, volume status, hemodynamicsThis part lays out a step-by-step bedside check for AKI on CKD, mixing patient story, key physical checks, fluid status, and blood flow review to quickly spot dangers and likely causes.
Key history elements in AKI on CKDFocused exam for perfusion and congestionBedside tools for volume status assessmentBlood pressure, MAP, and perfusion targetsRisk stratification for deterioration and ICU
