Deep Dive: Saving the Kidneys-Patients With AKI Still Need Medicine . . . and Food!

Video Transcription

Video Summary

This video transcript provides valuable information on the management of medication and nutrition therapy in patients with acute kidney injury (AKI). The speaker discusses the complexity of medication management in AKI and proposes strategies such as the kinetic estimated glomerular filtration rate (KE-GFR) and the use of cystatin-C to improve dosing accuracy. The KE-GFR takes into account the changing creatinine levels over time, providing a more accurate estimation of kidney function in unstable kidney function. Cystatin-C can also be used as an alternative biomarker for assessing kidney function and improving medication dosing, especially in unstable kidney function. <br /><br />The video also highlights the importance of nephrotoxin stewardship in AKI. Nephrotoxic medications are associated with one-third of AKI cases, and reducing nephrotoxin exposure can help prevent AKI and improve patient outcomes. The speaker discusses the use of the NINJA program as an example of successful nephrotoxin stewardship, which resulted in a significant decrease in nephrotoxin exposure and AKI incidence. <br /><br />In terms of nutrition therapy, the speaker emphasizes the challenge of balancing underfeeding and overfeeding in AKI patients. Energy requirements are recommended to be around 20-30 kilocalories per kilogram per day, and protein requirements range from 1.2 to 2 grams per kilogram per day. Estimating equations and indirect calorimetry can be used to determine energy requirements, but there is variability in their accuracy. Additionally, sneaky sources of fluid, sodium, and dextrose, such as medication diluents and maintenance fluids, should be considered to avoid fluid overload.<br /><br />Overall, this video provides valuable insights into the management of medication and nutrition therapy in patients with AKI, offering strategies and considerations for optimizing patient care.

Asset Caption

Erin F. Barreto

Keywords

acute kidney injury

medication management

nutrition therapy

kinetic estimated glomerular filtration rate

cystatin-C

nephrotoxin stewardship

energy requirements

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