CME Live: Session One

Curofy- India's largest community of verified doctors covered the CME-International Neonatal and Pediatric Nephrology Training Workshop live. This post was first published on the Curofy app. 

Non Dialytic Management of AKI: 

Dr. Rupesh Raina

Modified RIFLE criteria doesn't help on bedside

Creatinins is not the only marker neither is it good.
Solute clearance
Risk assessment
Early intervention is critical in golden hour
Normal saline is the best for fluid replacement - gives them proteins, hypercatabolic state
Contrast induced neprotoxicity should be avoided. No contrast MRI

Nutrition in AKI 

Dr. Timothy buchman

Protein energy waste= increased morbidity & mortality

Hypoglycemis:
Altered substrate utilization in acute illness:
Inefficient oxidation, impaired glycogenesis, lipogenesis
Insulin resistance

Protein metablism:
Muscle efflux of amino acid to fuel gluconeogenesis
Liver protein synthesis shifts from anabolic to acute phase proteins. 
Net negetive nitrogen protein balance

Lipid metabolism:
Increased triglyceride
Decreased cholestrol
Impaired lipolysis

Water soluble vitamins:

Vit B1 def. altered energy metabolism
Vit B6 def: altered amino acid and lipid metabolism
Folate deficiency: anemia
Vit c def: potential for losses during CRRT