Clinical meaning
Central Line Insertion & Bundle involves disruption of renal filtration, tubular function, electrolyte homeostasis, or acid-base balance specific to central line insertion & bundle.
Diagnosis & workup
Diagnostics & workup: - Serum creatinine with eGFR calculation (CKD-EPI equation) - ANCA, anti-GBM, anti-dsDNA for autoimmune renal disease - BUN/Creatinine ratio (>20:1 suggests prerenal etiology) - Complement levels (C3, C4) for glomerulonephritis workup - Renal biopsy for unexplained proteinuria, hematuria, or AKI - Renal ultrasound for size, echogenicity, obstruction, masses - Fractional excretion of sodium (FENa): <1% prerenal, >2% intrinsic renal
Risk factors: - Diabetes mellitus (leading cause of CKD, 44% of new ESRD) - Volume depletion from any cause - Hypertension (second leading cause of CKD) - Sickle cell disease with papillary necrosis - Rhabdomyolysis from trauma, statins, or extreme exertion - Family history of polycystic kidney disease or Alport syndrome - Autoimmune disease (SLE lupus nephritis, ANCA vasculitis)