Nursing School Study Checklist
What’s the pathophysiology of AKI?
If you’re super confused about it and wondering how to pass your renal exam in nursing school, stick around, because I’m going to give you a really easy breakdown of acute kidney injury pathophysiology.
TIMESTAMPS:
0:00 Intro
1:05 What is acute kidney injury?
1:20 What causes acute kidney injury?
3:04 What are the phases of acute kidney injury?
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VIDEO TRANSCRIPT
What’s the pathophysiology of AKI? If you’re super confused about it and wondering how to pass your renal exam in nursing school, stick around, because I’m going to give you a really easy breakdown of acute kidney injury pathophysiology. And before we dive in, I just want to make sure you download THE nursing school study checklist I have for you, that walks you through how to study for your med-surg nursing exams, step-by-step. The link is in the description for you to download it.
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Hey there friend, Christina here, and welcome to the Nursing School Show. I’m here to help you pass nursing school and become an AMAZING nurse. So if you want to rock nursing school without losing your mind, hit that subscribe button and click the notification bell and lets dive in!
Now, AKI is also called acute kidney injury, or acute renal failure. You’ll hear all of those terms, but they all mean one thing: the kidneys are injured, and we need to fix it.
Acute kidney injury happens when the kidneys are suddenly damaged, by things like certain medications, sepsis, or a lack of blood flow. This damage can be reversible, as long as it is treated promptly.
The causes of acute kidney injury are divided up into 3 main categories:
- Prerenal
- Intrarenal
- Postrenal
Prerenal refers to things that happen before the blood gets to the kidneys, or things that happen generally throughout the body (things like sepsis, heart failure, infection, or an obstruction that blocks blood flow to the kidneys). Sepsis is a big deal and nursing instructors LOVE to test you on it, so check out THIS video before you take your next exam. And if you’re a NursingSOS Member, head on over to your dashboard to check out the whole sepsis video series we have for you.
Now, intrarenal refers to things that happen within the kidneys, like a medication that damaged the nephrons themselves, kidney infection, or an obstruction within the kidney.
Postrenal means the cause is AFTER the kidneys, in the ureters, bladder, or urethra. These could be things like kidney stones (or renal calculi), benign prostatic hypertrophy, or a bladder infection. If you’re a NursingSOS Member, you’ll also want to check out the Renal/GU course we have for you that includes the video series on benign prostatic hypertrophy. That will help you learn it faster for your exam.
So really what it comes down it, is if the cause is generalized throughout the body, or if it’s something having to do with something OUTSIDE of the renal system, then it’s most likely considered prerenal. If it’s inside the kidney, it’s intrarenal. And if the cause comes after the kidneys in the urinary system, it’s postrenal.
Now, let’s walk through the phases or stages of acute kidney injury and the pathophysiology of what happens during AKI. Now these ARE actual stages that have been defined for AKI, so you absolutely need to know these for nursing school. You will most likely be tested on this. So here we go:
The first phase of AKI is onset or initiation.
In the onset phase, blood flow to the kidneys is decreased and the urine output starts to decline. The kidneys need blood flow to function properly. So when they don’t get enough blood, they aren’t able to do their job as well, so urine output will start to decrease. This phase can last anywhere from a couple hours to days.
The second phase of acute kidney injury is the oliguric phase, where the patient’s urine output is less than 400mL per day.
Because there isn’t enough blood flow going to the kidneys, they stop functioning properly, and can’t produce as much urine or get rid of as much waste as they should. So this will cause oliguria, which is a decrease in urine production, and an increase in waste products, such as creatinine and urea. This phase often lasts between one to 2 weeks. And if you want a super easy breakdown of renal labs, like creatinine and blood urea nitrogen, click on THIS video right here.
The third phase of AKI is the diuretic phase, and this will happen only if the kidneys get more blood flow, and the damage has stopped.
So if the cause of the AKI was fixed, the kidneys will slowly start recovering and working again. During this diuretic phase, it’s just what it sounds like, a lot of diuresis. The kidneys are coming back swinging, and they are getting rid of a lot of urine. So you might see the patient urinate between 4 and 5 liters per day, and this can last between 1 to 2 weeks.
The final phase is the recovery phase of AKI, which can take months to years for a full recovery.
As the kidneys heal over time, urine output starts to normalize again.
It is important to note, however, that if AKI isn’t fixed and if the damage to the kidneys progresses, it can lead to chronic kidney disease, and ultimately, renal failure.
Now make sure to like, comment, subscribe and share this video with a friend. And click on this med-surg playlist right here so you can rock your med-surg nursing class, and go become the nurse that God created only YOU to be. And I’ll catch you in the next video.
