(BQ) Part 2 book Transplantation at a glance has contents: Delayed graft function, transplant rejection, chronic renal allograft dysfunction, pancreas transplantation, islet transplantation, intestinal failure and assessment, intestinal transplantation,... and other contents.
21 End-stage renal failure (a) Temporal classification of renal failure GFR (mls/min/1.74m2) 100 Acute kidney injury Chronic kidney disease 10 Days Onset Aetiology Weeks Months Years Acute kidney injury (AKI) Chronic kidney disease (CKD) Days – weeks Months – years Pre-renal > Post-renal > Renal Renal > Post-renal > Pre-renal (b) Aetiological classification of renal failure Pre-renal Renal • Hypotension, sepsis • Glomerular pathology – Glomerulonephritis (1°, 2° to lupus, vasculitis), diabetic nephropathy • Interstitial pathology – Interstitial nephritis, chronic pyelonephritis • Vascular pathology – Thrombic microangiopathy, hypertensive nephropathy • Tubular pathology – Acute tubular necrosis, cast nephropathy • Renovascular disease Post-renal • Prostatic hypertrophy/cancer • Bladder pathology (stones, cancer) • Vesicourteric reflux (c) Staging of AKI and CKD AKI stage Serum creatinine Urine output criteria Increase of >26.4 µmol/L (0.3 mg/dL) or 150–200% of baseline (1.5–2 increase) 6 hours Increase to >200–300% of baseline (2–3 fold increase) >354 µmol/L (4 mg/dL) with an acute rise of at least 44 µmol/L (0.5 mg/dL) or >300% of baseline (3 fold increase) CKD stage eGFR (ml/min/1.73 m2) Other features 90+ 12 hours Normal renal function but urine dipstick abnormalities or known structural abnormality of renal tract or diagnosis of genetic kidney disease 24 hours or anuria for 12 hours 60–89 Mildly reduced renal function plus urine/structural abnormalities or diagnosis of genetic kidney disease 30–59 Moderately reduced renal function 15–29 Severely reduced renal function