UREA CREATININE KFT RFT - ICU BASICS DR TAPESH BANSAL🩺📽🎫
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- Опубликовано: 8 ноя 2024
- food for thought🤠🙋♂️🙋♀️
Can a person survive on one kidney?
ANS🤷♂️✔
YES , ELSE HOW A LIVE KIDNEY DONOR AND PT WILL LEAVE AFTER TRANSPLANT. the rational is as long as gfr is more than 50 ml per min it is adequate and creat wl be normal , at 30 yrs it 100 ml permin approx and therafter variably declines with aging
Dr.TAPESH BANSAL Summary
Uria, Creatinine,
He emphasized that renal failure is not the focus of this discussion, but rather the specific aspects of Uria and Creatinine. He also mentioned the importance of the blood urea nitrogen (BUN) to creatinine ratio and its relevance in certain situations. Furthermore, Dr. touched on the topic of glomerular filtration rate (GFR) and augmented regional clearance, indicating that these would be covered in future discussions.
Understanding Urea Cycle and Metabolism
Dr discussed the importance of understanding the urea cycle . He explained that urea is produced when ammonia is generated from amino acid turnover, which can be increased due to catabolic stress, steroid use, acute starvation, amino acid infusions, and upper gastrointestinal bleeding. Dr also highlighted the significance of pre-renal conditions, where a decrease in renal blood flow leads to increased urea absorption, causing a disproportionate rise in urea levels compared to creatinine..
Blood Urea Nitrogen and Creatinine Levels Discussion
Dr. discussed the importance of blood urea nitrogen (BUN) and creatinine levels in diagnosing kidney function. He emphasized that a BUN to creatinine ratio of more than 40 is indicative of pre-renal failure, which is reversible. He also explained that liver disease, malnutrition, and dilutional effects can cause low BUN levels. Dr. concluded by stating that there is no normal ratio for BUN to creatinine, as both values can vary. He also mentioned that liver disease can cause low creatinine levels.
Factors Affecting Creatinine Levels and Interpretation
Dr discussed the factors affecting creatinine levels, emphasizing that they are not solely indicative of kidney injury. He explained that muscle injury, surgery, meat ingestion, aspirin intake, and fluid overload can all impact creatinine levels. He also highlighted the importance of considering dilution effects, particularly in ICU patients, as muscle mass loss can lead to falsely low creatinine levels. Dr also mentioned that pregnancy and liver disease can affect creatinine levels.
Accurate Measurements and Kidney Function Discussion
Dr. discussed the importance of accurate measurements in the lab, particularly in relation to protein values and blood urea nitrogen (BUN) levels. He highlighted that certain drugs and conditions can lead to falsely low BUN levels and explained the concept of the BUN-to-creatinine ratio. , also discussed the relationship between creatinine levels and glomerular filtration rate (GFR) in the context of acute kidney injury. He emphasized the need to understand the current behavior of the kidney and the calculation of the GFR, and clarified the difference between Estimated GFR (eGFR) and Actual GFR.
Suggestions
• Clinicians to consider using blood urea/creatinine ratio and urine sodium levels to differentiate between pre-renal and renal causes of acute kidney injury.
• ICU team to be aware of augmented renal clearance in sepsis and trauma patients, and adjust antibiotic dosing accordingly to prevent treatment failure.
Great Effort sir
Thank you sir for making such Content
lectures on thyroid function, cortisol level interpretation, autoimmune markers will be helpful. thank you.
Ok
Thank you sir
Welcome
Thanks Sir ... This clears how & why of S.Creat & Blood Urea analysis. Please also make a video on PCT & CRP. Very often need to analyse their results in conjunction & it will be helpful... Thanks 😊😊😊
@@hiteshwadhwani5972 sure ,it wl take a while
Organizing an online conference on fluids .. coming up on 27th Oct with IFA, After that
@@hiteshwadhwani5972 glad u liked the video👍
@@youngindiaintensivist7709 Ur academic initiatives are an inspiration.. Wish you all the best & success ..
@@youngindiaintensivist7709 🙂🙂
@@hiteshwadhwani5972 thank you for the kind words
I wish u the same in ur growth and career❤👍
Plz make more video on case presentation rather than specific topic ( teaching 1 way is quite boring ) .. that helps to understand the scenario and better understanding of approach
@@krishmahat1343 I think u hv joined channel recently
We have done 30 actual case presentations from ICU s , unfiltered discussions
In fact our channel is the 1st one to do so
We hv stopped currently as interest was dwindling
Please go thru the playlists and find case presentations
U can find all impt cases
Pl give feedback then
@@youngindiaintensivist7709 already see those case presentation videos ., that was amazing .. missing this type of videos .. can you make those type in future ?? .. Dr tapas question was really amazing and the way he highlights important things is really difficult to get in books ..
glad you liked the case discussions, as for now we are not doing cases as audience interest has decreased and all-important cases are put up, yes definitely after sometime we shall do more cases