What’s in a name … - PowerPoint PPT Presentation

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What’s in a name …

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  1. What’s in a name … “Bangers” or “Sausages”

  2. Clinical Example – “Mr. Smith” • History: 76 yo male with h/o Diabetic Nephropathy, CKD (at baseline Cr 2.6 and GFR 29), CHF (EF 35%) presents with chest pain and admitted for NSTEMI, taken to Cath Lab for coronary angiography. Over next 3 days, Cr noted to increase to 5.1

  3. Documentation Impact POOR GOOD Acute Tubular Necrosis 2/2 CIN CKD stage 4 Chronic Systolic Heart Failure Expected Length of Stay = 5 Days • Contrast Induced Nephropathy • CKD • CHF filler filler filler fillerfi Expected Length of Stay = 2 Days

  4. Consider Documenting “likely ATN” when patients with AKI had: • IV contrast (CT scan, cardiac cath) • Medications (abx, antifungals, cytotoxins, etc.) • Rhabdomyolysis, myoglobinuria • Prolonged ischemia/hypotension/shock/sepsis

  5. Consider Documenting “likely ATN” when: • AKI lasting > 3 days s/p IV fluids • FENa > 2% (except CIN = variable FENa) • UA – “muddy brown” granular casts (pathognomonic)