case presentation on Acute Kidney Injury. AKI is reservisible loss of kidney function which leads to increase in serum creatinine and BUN over the course of hours to weeks.

1. CASE PRESENTATION ON ACUTE
KIDNEY INJURY
SUBMITTED BY:
CH.BINDU MADHAVI
III/VI PHARMD
Y17PHD0805
DEPARTMENT OF PHARMACY PRACTICE

2. Brief summary about the case:
• A male patient of age 50 years was admitted in the hospital with C/O
mild SOB ,c/o pedal edema, icterus. He is a mixed diet person. His
appetite is moderate and bowel habits are regular. The bladder habits
were decreased. He was diagnosed as having ACUTE KIDNEY
INJURY. Followed by standard treatment the patient was normalized.
The above case was presented in the form of SOAP analysis.

3. SUBJECTIVE DATA:
A male patient of age 50 years was admitted in the hospital with C/O
mild SOB ,c/o pedal edema, icterus. He is a mixed diet person. His
appetite is moderate and bowel habits are regular. The bladder habits
were decreased.

4. OBJECTIVE DATA:
• PHYSICAL EXAMINATIONS:
• Pt- conscious BP- 140/80mmHg PR- 88 beats/min
• RR- 20 cycles/min Sp𝑂2 - 98% 𝑃0 𝐼1 𝐶0 𝐶0 𝐿0
• SYSTEMIC EXAMINATIONS:
• CVS- 𝑆1 𝑆2
+
RS - BA𝐸+
CNS- NFND
P/A- soft

5. Laboratory investigations:
Haematology 11/11/19 12/11/19 13/11/19 14/11/19
APTT [27.4-35.8sec] 26.3 sec
LYMPHOCYTES [ 20-45%] 11%
PROTHROMBIN TEST TIME [10.5-13.1 sec] 15.7 sec
WBC [4400-11000] 22200/cu.mm 21000/cu.mm
RBC [4.5-6.5 million/cu.mm] 3.81million/cu.mm
HAEMOGLOBIN [14-18g/dl ] 10.8g/dl 11.3g/dl 11.8g/dl 12g/dl
HAEMATOCRIT [ 42-54%] 31.2%
PLATELET [ 1,50,000-4,00,000/cu.mm] 27000/cu.mm 83000/cu.mm
RDW [11.6-14%] 14.5%

6. BIOCHEMISTRY 11/11/19 12/11/19 13/11/19 14/11/19
SERUM BILIRUBIN TOTAL [ 0.10-
1.20mg/dl]
20.42 mg/dl 24.42 mg/dl 24.39 mg/dl 17.32 mg/dl
SERUM BILIRUBIN DIRECT [ 0.00-
0.30 mg/dl]
17.92 mg/dl 15.44 mg/dl
BILIRUBIN INDIRECT [ 0.10-
0.80mg/dl ]
2.5 mg/dl 1.88mg/dl
SERUM SGOT/AST [ 0-40 IU/L ] 46 IU/L
SERUM CREATININE [ 0.90- 1.30] 3.5 mg/dl 3.30 mg/dl 2.6 mg/dl 1.90mg/dl

7. OTHER INVESTIGATIONS:
• ECG: Normal sinus rhythm
possible left atrial enlargement
non specific ST abnormality
abnormal ECG
• 2D ECHO/COLOR/DOPPLER REPORT:
IMPRESSION: mild LV
no RWMA of LV
Normal LV systolic function
Mild MR
Mild TR/PAH

8. • REAL TIME ULTRASONOGRAPHY OF THE ABDOMEN:
IMPRESSION- Mild enlarged bilateral kidneys with grade I
parenchymal changes- AKI
Minimal ascites
Left minimal pleural effusion
[right – 13.5×5.7cm & left - 13× 5.1 cm]

9. ASSESSMENT:
• Based on the subjective and objective data the final diagnosis was
found to be ACUTE KIDNEY INJURY
• DEFINITION:
• Acute kidney injury (AKI) or acute renal failure (ARF), is commonly
defined as an abrupt decline in renal function, clinically manifesting
as a reversible acute increase in nitrogen waste products—measured
by blood urea nitrogen (BUN) and serum creatinine levels—over the
course of hours to weeks.

10. • ETIOLOGY:

11. RISK FACTORS:

12. PATHOPHYSIOLOGY:

14. CLINICAL PRESENTATIONS:

15. GOALS:
• To reduce signs and symptoms using symptomatic therapy
• To reduce disease progression
• To prevent further complications
• To improve the quality of life of patient

16. Drug information:
S.NO NAME OF THE DRUG DOSE ROA FRE
Q
DURA CATEGORY INDICATION
1. INJ.MONOCEF
(ceftriaxone)
1gm IV BD D1-D4 2nd generation
Cephalosporins
Used to treat bacterial
infections.
2. INJ.DOXY
( doxycycline)
100
mg
IV BD D1-D4 Tetracyclines Used to treat bacterial
infections.
3. INJ.AZITHROMYCIN
(azithromycin)
500
mg
IV OD D1-D4 Macrolide Used to treat bacterial
infections.
4. T.PANTOCID
(pantoprazole)
40 mg P/O OD D1-D4 Proton pump inhibitor prophylactic
5. T.NEPHYIT 10 mg P/O OD D1-D3 Minerals Used as mineral
supplement

17. S.N
O
NAME OF THE DRUG DOSE ROA FREQ DURA CATEGORY INDICATION
6. INJ.VIT – K
(vitamin k)
10mg/
ml
IV OD D1-D3 Vitamin K
supplement
Used to treat vitamin
K deficiency
7. T.HEPTAGON
(Multivitamin)
I tab P/O BD D1-D2 Multivitamin Used to treat vitamin
deficiency
8. SYP.POTKLOR
(KCL)
15 ml P/O TID D1-D4 Potassium
supplement
Used to treat
hypokalaemia
9. NEB DUOLIN
(salbutamol+ ipratropium)
2.5+0.5
mg
P/N QID D1-D4 𝛽2 adrenoreceptor
antagonist
anticholinergic
Used to treat SOB
10. CAP.UPCOUNT
(carica papaya extract)
1 cap P/O OD D2-D4 Platelet booster Used to increase
platelets
11. T.UDILIV
(ursodeoxycholic acid)
300 mg P/O TID D2-D4 Gall stone
dissolving agent
Used to treat icterus
condition.

18. PATIENT COUNSELLING:
ABOUT DISEASE:
AKI is a sudden episode of kidney failure or kidney damage that happens
with in few hours or few days.
ABOUT DRUGS:
T. Pantocid- administer early morning 1 hr before meals.
T.Udiliv- should be taken with food.
Inj.Monocef- Do not mix ceftriaxone in the same injection with
other antibiotics, or with any diluent that contains calcium, including a TPN
(total parenteral nutrition) solution.
Inj.vitamin k- If this medication is given into a vein, it should be injected very
slowly (no more than 1 milligram per minute) to reduce the risk of serious
side effects.
Cap.Upcount- administer with food.

19. LIFESTYLE MODIFICATIONS: