What's Covered

• Definition - KDIGO criteria (SCr rise ≥0.3 mg/dL in 48h, or ≥50% in 7 days, or urine output <0.5 mL/kg/h)
• Staging - KDIGO Stages 1-3 with SCr and UO criteria; RIFLE comparison
• 3-category classification - Prerenal (~55%), Intrinsic (ATN, GN, AIN, vascular), Postrenal (~10%)
• Pathophysiology of ischemic ATN (4 phases), vulnerable nephron segments
• Diagnosis - urinalysis, FeNa/FeUrea, biomarkers (NGAL, KIM-1, cystatin C), urine sediment interpretation
• Management with doses - fluids, hyperkalemia ladder (calcium gluconate → insulin/dextrose → patiromer/ZS-9), furosemide dosing, nutrition targets, uremic bleeding
• RRT - AEIOU indications, IHD vs CRRT vs SLED vs PD

• Definition - structural or functional abnormality >3 months
• KDIGO staging - G1-G5 by eGFR + A1-A3 by albuminuria
• Causes - DKD (40%), hypertensive nephrosclerosis, GN, ADPKD, APOL1 genetics
• Pathophysiology - hyperfiltration, proteinuria-driven fibrosis, RAAS activation
• Complications - anemia, CKD-MBD, metabolic acidosis, hyperkalemia, CVD (each with management and doses)
• Slowing progression - ACEi/ARB + SGLT2 inhibitors (dapagliflozin/empagliflozin) + finerenone ("triple therapy" in DKD)
• Mineral bone disease - step-by-step: native vitamin D → phosphate binders → active vitamin D → cinacalcet (dialysis only)
• RRT planning - indications, modalities, vascular access timing