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Acute Kidney Injury

Nurses   (399 Views | 7 Replies)

50 Profile Views; 3 Posts

Is it normal for a patient to be diagnosed with AKI, but have a normal BUN, CR, Na and is hypokalemic?

Edited by Future Nurse In Training

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Adri0418 has 2 years experience as a ADN, RN and specializes in Hemodialysis.

43 Posts; 1,634 Profile Views

Is this an assignment? 

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3 Posts; 50 Profile Views

No. It's a question I asked myself when looking at a diagnosis for AKI, but there was no increase in BUN, Cr, K. 

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Adri0418 has 2 years experience as a ADN, RN and specializes in Hemodialysis.

43 Posts; 1,634 Profile Views

It is not normal. For all my AKI patients the BUN and creatinine are elevated. Nephrology is consulted and patients are usually started on dialysis. Some patients truly are AKI and a underlying condition needs to resolve, but the labs are 100% of the time elevated, so very strange that the ones you are implementing were not.

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149 Posts; 377 Profile Views

you can have an AKI with a normal BUN/Cr as per the lab ranges. An aki is considered a 1.5 increase in Cr within 48 or so hours. There are a few more definitions such as 0.3 increase In cr  or UOP less than .5ml/kg/hr x 6 hours

 

So it’s likely not a misdiagnosis

9 hours ago, Adri0418 said:

It is not normal. For all my AKI patients the BUN and creatinine are elevated. Nephrology is consulted and patients are usually started on dialysis. Some patients truly are AKI and a underlying condition needs to resolve, but the labs are 100% of the time elevated, so very strange that the ones you are implementing were not.

They only started on dialysis if renal failure not aki

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marienm, RN, CCRN has 6 years experience and specializes in Burn, ICU.

223 Posts; 4,469 Profile Views

Did the AKI diagnosis come from the patient's problem list in the electronic medical record? At my hospital, every current problem as well as chronic but relevant conditions are listed there. It can be helpful (it's good to know that a patient with an acute bowel obstruction also has COPD) or it can be confusing (such as the patient who was hyperkalemic on admission 3 weeks ago due to compartment syndrome and has never been hyperkalemic since their fasciotomy...but the problem list still says "hyperkalemia")

Just speculating about whether the listing of AKI is still a current diagnosis... 

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BostonFNP has 9 years experience as a APRN and specializes in Adult Internal Medicine.

1 Follower; 3 Articles; 5,238 Posts; 901 Profile Views

AKI is diagnosed on the basis of a sudden reduction in renal function as measured elevation of serum Cr (>0.3mg/dL or 150% increase in serum Cr), reduction in urine output (<0.5mL/kg/hr for >6hours), or need for renal replacement. 

It also may have happened earlier in the hospital course/ED.

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