Clinical meaning
Fluid, Electrolyte, and Acid-Base Management involves disruption of renal filtration, tubular function, electrolyte homeostasis, or acid-base balance specific to fluid, electrolyte, and acid-base management.
Diagnosis & workup
Diagnostics & workup: - Comprehensive metabolic panel (electrolytes, calcium, phosphorus, bicarbonate) - BUN/Creatinine ratio (>20:1 suggests prerenal etiology) - CBC for anemia of CKD evaluation - Serum creatinine with eGFR calculation (CKD-EPI equation) - Urinalysis with microscopy (casts, crystals, cells) - ANCA, anti-GBM, anti-dsDNA for autoimmune renal disease - Renal biopsy for unexplained proteinuria, hematuria, or AKI
Risk factors: - IV contrast administration (contrast-induced nephropathy) - Hypertension (second leading cause of CKD) - Nephrotoxic medications (aminoglycosides, vancomycin, amphotericin B) - Diabetes mellitus (leading cause of CKD, 44% of new ESRD) - Age >60 with age-related GFR decline - Volume depletion from any cause - Rhabdomyolysis from trauma, statins, or extreme exertion