James talks to Professor Steve Chadban about acute kidney injury (AKI). AKI develops in 5 – 20% of hospitalised patients and is a significant contributor to morbidity and mortality in the critically ill. Acute kidney injury ranges from mild to severe disease requiring renal replacement therapy. Here, we’ll deconstruct the causes of AKI to outline a helpful and systemic approach for junior doctors.
Summary Writer: Amanda White
Editor: James Edwards
Interviewee: Steve Chadban
Steve Chadban studied Medicine at the University of Newcastle, Australia, where he received the University Medal in Medicine. He undertook physician training in Newcastle, before specialising in Nephrology, completing a PhD in macrophage biology at Monash University, then a post-doctoral study period in immunology at the University of Cambridge, UK.
Steve returned to Monash University to run the Transplantation Program from 1999–2002 before moving to Royal Prince Alfred Hospital, where he is a full-time staff Nephrologist, Director of Kidney Transplantation, Professor of Medicine (Nephrology) at The University of Sydney and researcher in basic and clinical sciences. Steve is the President-elect of the TSANZ, Executive member of ANZDATA and a Lead Investigator in the AusDiab Kidney Study. He has spoken at numerous National and International meetings and produced over 170 papers published in leading international journals including The New England Journal of Medicine, JAMA and The Journal of Clinical Investigation.
Steve’s research interests include the molecular mechanisms of transplant rejection, with a focus on macrophages and innate immunity, clinical transplantation, diabetes and outcomes in CKD and transplantation.
With Professor Steve Chadban, Renal Physician at Royal Prince Alfred Hospital, New South Wales, Australia
Acute kidney injury (AKI) encompasses an entire spectrum from mild, temporary impairment to severe disease requiring renal replacement therapy. It develops in 5-20% of hospitalised patients and is a significant contributor to morbidity and mortality in the critically ill. Having an efficient and methodical approach to investigating AKI can turn a seemingly complex scenario into a fairly straight-forward problem for the junior doctor to manage. In this podcast, we will deconstruct the myriad causes to outline a helpful, systemic approach to investigating and managing such patients.
As the junior doctor covering the orthopaedic ward on the weekend, a nurse calls you as he is worried about one of his patients, a 30-year-old man who is 24 hours post intramedullary fixation of a fractured femur sustained in a high-speed motorbike accident. It appears that his urine output has been trending steadily down, and he has only produced 70mLs of urine in the last 6 hours.
You arrive to the ward and note the bladder scan result of 10mLs. You notice that his routine blood tests from earlier this morning show that his creatinine had increased to 180mmol/L.
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