Lesson 1Urine studies and interpretation: urinalysis, urine sediment microscopy, urine electrolytes, fractional excretion of sodium and ureaThis part shows how to collect and read urine tests in AKI on CKD, like urinalysis, looking at urine sediment under microscope, urine salts, and excretion rates, to tell if it's from low blood flow, kidney damage itself, blockage, or something else.
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 covers urgent problems in AKI on CKD like high potassium, bad acid buildup, lung water, and waste buildup symptoms. It stresses quick fixing and when to rush into 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 sudden and long-term changes, and how this guides outlook, close watching, and when to call a kidney 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 explains why acute kidney injury hits on chronic kidney disease, separating blood flow issues, direct kidney damage, and blockage causes, linking them to patient signs, tests, and targeted fixes.
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 shows how to spot and treat fixable AKI triggers in CKD patients, like infections, kidney-damaging drugs, low or too much fluid, and blockages, focusing on quick action to stop more kidney harm.
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 explains when and how to use scans in AKI on CKD, like kidney ultrasound for blockages, bladder checks for urine hold-up, and quick bedside ultrasound 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 lab results in AKI on CKD, like creatinine changes over time, BUN to creatinine ratio, salts, acid-base balance, and lactate, to separate new from old kidney issues and guide urgent steps.
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 covers choices for dialysis in AKI on CKD, when to start, timing arguments, and picking between regular dialysis, continuous types, or slower ones based on blood pressure stability, available tools, 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 talk between ICU, emergency, main teams, and nurses for urgent AKI care, building common understanding, clear job sharing, escalation signs, and standard handovers for better safety and results.
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, targeted exam, fluid status check, and blood flow review to quickly find life dangers and likely AKI 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
