Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Acute Renal Failure and Renal Replacement Therapy

Video Transcription

Video Summary

The video discusses the etiologies and management of acute kidney injury (AKI) in pediatric patients. The presenter begins by discussing a case of a 10-year-old patient who developed AKI following surgery and subsequent infections. He goes on to explain the different etiologies of AKI, which include pre-renal, renal, and post-renal causes. The presenter emphasizes the importance of understanding glomerular filtration rate (GFR) and how it is measured. He also discusses the classification of AKI and the criteria used to diagnose it. The management of AKI involves evaluating the extent of the injury, discontinuing nephrotoxic agents, ensuring adequate volume status and kidney perfusion, and considering renal replacement therapy if necessary. The presenter explains the different modalities of renal replacement therapy, including peritoneal dialysis, intermittent hemodialysis, and continuous renal replacement therapy. He also briefly discusses the management of AKI in the ICU, including optimizing cardiac output and renal blood flow, treating complications, and considering initiation of renal replacement therapy. The video concludes with a board-style question about the management of diuresis in a patient with AKI. The correct answer is to begin treatment with metolazone, a thiazide-style diuretic, as it would work synergistically with the loop diuretic bumetanide to achieve additional diuretic effect.

Keywords

acute kidney injury

pediatric patients

etiologies

management

glomerular filtration rate

renal replacement therapy

peritoneal dialysis

diuresis

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