Approach to the Critical Patient

Immediate priorities

Life threats in obstructive AKI

Time critical actions

Monitoring and targets

Monitoring bundle

Escalation triggers

Immediate consults

Consultation triggers

History

Onset and urinary pattern

Urine output trajectory

Lower urinary tract symptoms

Pain and associated symptoms

Pain pattern

Associated features

Risk factors and triggers

Demographic and structural risks

Medication and procedural triggers

Important negatives

Physical Exam

Vitals and volume status

Vital sign clues

Volume assessment

Abdominal and urologic exam

Abdominal findings

Targeted urologic exam

PITFALLS

Diagnostic traps

Differential Diagnosis

By category of AKI

Post-renal obstructive causes

Prerenal AKI mimics

Intrinsic renal causes

Hard to detect obstruction

Non-dilated obstructive uropathy

Other vascular and pressure mimics

Laboratory Tests

Renal and electrolyte panel

Basic metabolic profile

Mineral and supportive labs

Urine studies

Urinalysis

Fractional excretion of sodium

Sepsis and adjunct labs

Infection markers

Specialized markers

Diagnostic Tests

Scoring Systems

KDIGO AKI staging

Prognostic considerations

MRI

MR urography role

Contraindications and limits

CT

Non-contrast CT abdomen and pelvis

Contrast considerations

Ultrasound

Renal and bladder ultrasound first line

Point of care ultrasound

Disposition

Level of care

Admission indications

ICU indications

Discharge and follow up

Discharge criteria

Follow up plan

Treatment

Initial stabilization

Resuscitation basics

Relieve obstruction

Lower tract obstruction

Upper tract obstruction

Hyperkalemia management

Membrane stabilization

Intracellular shift

Potassium elimination

Infection and supportive care

Antibiotics for infected obstruction

BPH directed therapy

Post-obstructive diuresis care

Nephrotoxin and medication review

Hold or adjust nephrotoxins

Avoid further insults

Special Populations

Pregnancy

Pregnancy considerations

Geriatric

Older adult features

Pediatrics

Pediatric differences

Background

Epidemiology

Burden and frequency

Etiologic distribution

Pathophysiology

Mechanism of injury

Determinants of recovery

Therapeutic Considerations

Definitive management principle

Outcome optimization

Patient Discharge Instructions

copy discharge instructions

Home care after obstruction relief

Return to ER warning signs

Follow up

Self-care tips

References

Guidelines and key sources

Guideline sources

Evidence summaries

Coding standards

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.