Renal angina

Renal Angina

Renal Angina

Renal angina is a clinical concept used to identify patients at high risk for developing acute kidney injury (AKI). It serves as a predictive tool to guide early intervention and management strategies in patients who are susceptible to kidney damage. The term "renal angina" draws an analogy to "angina pectoris" in cardiology, where chest pain serves as a warning sign for potential myocardial infarction.

Pathophysiology

Renal angina is based on the understanding that certain clinical conditions and risk factors predispose patients to AKI. These include pre-existing chronic kidney disease, sepsis, heart failure, and exposure to nephrotoxic agents. The concept emphasizes the importance of recognizing these risk factors early to prevent the progression to overt kidney injury.

Clinical Criteria

AKI Stratification Criteria

The identification of renal angina involves assessing both clinical risk factors and early signs of kidney dysfunction. The criteria for renal angina include:

• Risk Factors: Conditions such as diabetes mellitus, hypertension, and advanced age.
• Early Signs: Subtle changes in serum creatinine levels or urine output that do not yet meet the full criteria for AKI.

The use of a "renal angina index" can help quantify the risk and guide clinical decision-making.

Diagnosis

The diagnosis of renal angina is primarily clinical, relying on the integration of risk factors and early laboratory findings. Advanced diagnostic tools, such as biomarkers of kidney injury, are being investigated to improve the sensitivity and specificity of renal angina diagnosis.

Management

Old AKI Tests

Management of patients with renal angina focuses on mitigating risk factors and closely monitoring kidney function. Strategies include:

• Avoidance of Nephrotoxins: Careful use of medications that can harm the kidneys, such as certain antibiotics and nonsteroidal anti-inflammatory drugs.
• Optimizing Hemodynamics: Ensuring adequate blood pressure and fluid balance to maintain renal perfusion.
• Early Intervention: Initiating treatment at the first sign of kidney dysfunction to prevent progression to AKI.

Prognosis

The prognosis of patients with renal angina depends on the timely recognition and management of risk factors. Early intervention can significantly reduce the incidence of AKI and improve overall outcomes.

Related Pages

• Acute kidney injury
• Chronic kidney disease
• Nephrology
• Sepsis

Renal Angina Index

See Also

• Nephrotoxicity
• Glomerular filtration rate
• Renal replacement therapy