Current Events > Need help from a Pharmacist/Medical Professional on CE:

(+) Yeah! (+)

Just a question, what constitutes as severe renal impairment? Is that AKI or CKD or both? I'm looking at this drug and just want to know.

@Super_Saiyan_3_Goku
@DezDroppedFreak
@DarkRoast

Why is this shit so ambiguous

AKI is kind of an abrupt (within ~48 hrs) reduction of kidney function often due to dehydration, nephrotoxic drugs, low cardiac output, IV contrasts, major surgery or shock syndromes. Resolution back to baseline renal function may return maybe within 2 weeks if you take appropriate actions (hydrate, remove offending agents, clear post-renal obstruction, etc).

CKD is more of a progressive disease marked by a continuous decline in renal function. People who have CKD can also go into AKI due to one or more reasons described above, but their resolution of symptoms take them back to whatever their baseline was before the insult.

As a rule of thumb, I would say someone with severe renal impairment has a CrCl < 30 ml/min, which is basically Stage 4 CKD. That's about the time you might need to begin preparations for dialysis.

I make renal dose recommendations based on trends and not singular values. I want to see whether the renal function status is getting better or worse over time.

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How's dialysis?

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breh, just breh

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Super Saiyan 3 Goku posted...

AKI is kind of an abrupt (within ~48 hrs) reduction of kidney function often due to dehydration, nephrotoxic drugs, low cardiac output, IV contrasts, major surgery or shock syndromes. Resolution back to baseline renal function may return maybe within 2 weeks if you take appropriate actions (hydrate, remove offending agents, clear post-renal obstruction, etc).

CKD is more of a progressive disease marked by a continuous decline in renal function. People who have CKD can also go into AKI due to one or more reasons described above, but their resolution of symptoms take them back to whatever their baseline was before the insult.

As a rule of thumb, I would say someone with severe renal impairment has a CrCl < 30 ml/min, which is basically Stage 4 CKD. That's about the time you might need to begin preparations for dialysis.

I make renal dose recommendations based on trends and not singular values. I want to see whether the renal function status is getting better or worse over time.

So looking at post #2 (It's Acetazolamide) would you use this in a patient with AKI?

If so, damn how'd this get past the rounding team and two pharmacists verifying smh

are you the patient, tc?

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ToPoPO posted...

Just a question, what constitutes as severe renal impairment? Is that AKI or CKD or both? I'm looking at this drug and just want to know.

@Super_Saiyan_3_Goku
@DezDroppedFreak
@DarkRoast

It depends on whether or not it's acute (AKI) or chronic (CKD). Renal impairment is defined as a decrease in GFR of at least 30% from baseline - Acute being less than a few months before improving, and chronic being > a few months without much improvement.


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ToPoPO posted...

So looking at post #2 (It's Acetazolamide) would you use this in a patient with AKI?

If so, damn how'd this get past the rounding team and two pharmacists verifying smh

It would probably flag in our hospital's EMR system for somebody with CrCl < 30, so that's a conversation that I'd have with the ordering provider.

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MaddenDude-- posted...

are you the patient, tc?

Do you need to consult with nephro?

Super Saiyan 3 Goku posted...

It would probably flag in our hospital's EMR system for somebody with CrCl < 30, so that's a conversation that I'd have with the ordering provider.

Okay, cool, just making sure, and yeah I believe they are aware, thanks everyone for your help!

Nephro consult: "Either give fluids or take away fluids, either way the kidney gets better and we get the credit"

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dialysis = very painful procedure.

even though it isn't :(.
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ToPoPO posted...

Do you need to consult with nephro?

huh

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