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 salts, and excretion rates, to tell apart causes before the kidney, in the kidney, or after, for better diagnosis.
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 sudden problems from AKI on CKD needing quick action, like high potassium, bad acidosis, lung water buildup, and waste buildup signs, focusing on steadying the patient 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 sudden 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 on chronic kidney injury happens, sorting blood flow issues, kidney itself problems, and blockages after, linking them to patient signs, tests, and treatments that fit.
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 causing AKI in CKD that can be reversed, like infections, kidney poisons, low or too much fluid, and blockages, stressing quick fixes 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 tells when and how to use scans in AKI on CKD, like kidney ultrasound for blockages, bladder checks for holding urine, and quick 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 issues and guide quick 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 covers choices for kidney replacement in AKI on CKD, signs to start, timing talks, and picking between regular dialysis, continuous replacement, or slow low dialysis based on patient stability, resources, 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, focusing on shared understanding, clear job sharing, warning 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 check, and blood flow review to quickly spot 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
