Definition
has a uniqueness that is fast growing
characterized
has
a uniqueness
by athat
reversible
is fast growing
increase in the blood concentration of
Definition
characterized by a reversible increase in the blood concentration of
Pathophysiology
Depressed Renal Blood Flow
Acute Tubular Necrosis
Apoptosis and Inflamatory Process
Vasoconstriction
Isothenuria,Restoration and
Associated Complication
Clinical Manifestations
Skin :and Eyes
Ears
Cardiovascular
Abdomen
Pulmonary
: : Rales,Hemopthysis
: System
Keratitis,Iritis,Uveitis,Jaundice
: Irregular Rhytmhs, Murmur, VJ Distention
Differential Diagnosis
Dehydration
Gastrointestinal (GI) bleeding
Heart failure
Chronic renal failure
Urinary obstruction
Urinary tract infection
Diabetic ketoacidosis
Diagnostic
Treatment
Correction of fluid overload with furosemide
Correction of severe acidosis with bicarbonate
administration, which can be important as a bridge to
dialysis
Correction of hyperkalemia
Correction of hematologic abnormalities
Avoid Nephrotoxic agents
Dopamine infusion
Type of fluid administration
Fluid administration
Diuretics
Nutritional Support
Renal Replacement Therapy (RRT)
Prognosis
The prognosis for patients with AKI is directly
related to the cause of renal failure and, to a
great extent, to the presence or absence of
preexisting kidney disease (estimated GFR
[eGFR] < 60 mL/min), as well as to the
duration of renal dysfunction prior to
therapeutic intervention. In the past, AKI was
thought to be completely reversible, but
long-term follow-up of patients with this
condition has shown otherwise.
Case Review
Name
:N
Age
: 7 years
Sex
: Male
RM
: 00.63.82.74
Address
: Dusun IX Purwosari
Date of Admission : April,5 2015
History
Main Complaint
: Fever
Feeding History
The patient got exclusive breast milk until 4 months, continue with
MP-ASI (Promina) from 6 until 8 Months. From 8 Months-2 Years, He
Got Poured Rice.
History of Immunization
The patient immunization was completed
Physical Examination
Generalized status
Body weight : 17 kg
Body length : 122 cm
Body weight in 50th percentile according to age : 24 kg
Body length in 50th percentile according to age : 123cm
Body weight in 50th percentile according to
body length : 24 kg
BW/Age : 17/24 = 70%
BL/Age : 122/123 = 99%
BB/TB : 17/24 = 70 %
Presence Status
Sensorium: Compos Mentis, HR =
120 bpm, RR= 40 x/min,
temperature: 38,5oC. Anemic (+),
dyspnea (+), cyanotic (-), edema (-),
icteric (-). Body weight (BW): 17 kg.
Body length (BL): 122 cm. CDC:
BW/Age = 70 %%, BL/Age = 99%,
BW/BL = 70%
Localized Status
Head : Eye: light reflex (+/+), isochoric pupil, pale inferior
conjunctiva palpebra (+/+). Ear/ Nose/ Mouth: within normal limit/
O2 nasal canule / within normal limit.
Neck : Lymph NodeEnlrgement (-)
Thorax :Symmetric fusiform, retraction (+) Epigastric Retraction,
HR: 120 bpm, regular, murmur (+),gallop,RR: 40 x/minute,
regular, ronchi (-/-)
Abdomen : Ascites (+), Smily Umbilical (-), peristaltic (+) normal.
Liver : not palpable
Spleen : not palpable
Extremities : Pulse 120 bpm, regular, adequate pressure/volume,
Warm Extremity, CRT < 3, TD : 110/80 mmHg
Genitalia: Male, within normal limit.
Lab Report
Hb/Ht/Leukosit/Trom : 10,7/37,8/10.390/171.000
Peripheral Blood Gas,
Ph/PCO2/PO2/PHCO3/TCO2/BE/SaO2 :
7,417/25.7/128,7/16,2/16,9/-7,3/98,9 %
Albumin : 2,9 mg/dl
Blood Glucose : 145 mg/dl
Ureum/Creatine : 58,6/0,91
GFR :73,7
Ca/Na/K/Cl : 7,9/134/3,3/105
PCT : 133,47 mg/ml
Differential Diagnostic
Acute Glomerunephritis
Congestive Heart Failue e.c Acyanotic
CHD
Nephrotic Syndrome
Working Diagnosis
Acute Glomerunephritis + CHF e.c
Acyanotic CHD
Therapi
FOLLOW-UP
Asto : 200
CRP Kualitatif : positif
PCT : Menyusul
Discussion
Theory
Observation in Report
Summary
This patient was diagnosed with Acute
Kidney Injury caused Glomerunephritis
post streptococci. Diagnosis is by
history taking, clinical symptoms, and
laboratory tests. Patients were treated
according etiologic cause, in this case
the cause is GNPs. Symptomatic
treatment also depends symptoms
appear.