ACUTE KIDNEY INJURY | Pre-renal, Intrinsic renal and Post-renal azotemia | USMLE STEP 1

[@owaisdurrani5962]

explained nicely. post obstruction failure not explained elsewhere like you did. great job brother.

[@absolutetuber]

this guy is going to make a great IM subspecialist

[@hendalsh2270]

Yeeeey finally I'm gonna understand this topic 😍😍

[@Meetpatel-pu6me]

Hend alsh haha i am happy :))

[@pubalidola3829]

Thank u so much for this video... u saved me from my exam🙏🙏❤

[@taracunningham136]

Thank you for this video. I was having difficulty understanding these concepts. Very well presented.

[@freethinker3495]

the BUN in prerenal azotemia increases because decreased perfusion stimulates RAAS. ADH augments urea reabsorption and not crearinine hence increased bun to cr. tatio

[@hassanmohamedahmedomar5935]

Really this video helped me , thanks for your simplified exaplanation.

[@doctorkhizar]

Salam bro why you stop making videos. You are very good in clearing the issues.

[@DrNiteshRaj]

what a superb concept sir.....

[@madhuekanayake5721]

Really informative lecture..thank you very much sir..🙂 Can you please tell the answer for this too.. True or false Increase serum Creatinine seen in b)Myocardial infarction d) Early DM nephropathy

[@soumitradas6160]

Its a good one...most importantly palatable one😀👍👍👍 Please upload the "CKD" as well thank you 🙏

[@pritishrestha5310]

Thanx a lot Dr Patel for the first time understood the concept....

[@susanharvey3593]

Thank you so much for this, I understand it better than I ever have!!!

[@62.sayantikadhar49]

Great explanation👏, please make videos on general pharmacology 🙂

[@Meetpatel-pu6me]

Sure. Will try to do it in the future

[@muzdalfaibadullah9589]

Finally I find the great vedio

[@tayebahchaudhry8065]

Thanks a lot for sparing ur time to help others!!! Very helpful videos. Any lecture on basal ganglia. That inhibition, dis-inhibition always confuses me. thanks!

[@Meetpatel-pu6me]

Tayebah Chaudhry thank you.... yess i will try to make a video on that.

[@tayebahchaudhry8065]

Thank u again!

[@Yupi214]

Can u plz make video on step1 acid base concept and winter formula

[@monika246]

Ur all explanations are just perfect😊

[@heyitsdiamedico5538]

Very clear explanation. Thank you so much ❤️ ❤️

[@meghasa8416]

Beautifully explained. Thank you so much :)

[@ujjawalshriwastav.1115]

Can you tell regarding Urine creatinine/Plasma creatinine ? Can't get it for pre renal, renal and post renal. You missed this one in the video. Rest all are clear.

[@B_hope1]

Great explanation 😍😍

[@srinivasanaravindhasamy5575]

Which book are you referring

[@fatimaahmarZ]

but in acute tubular necrosis and post renal azotemia when BUn :cr ratio is decreased then why we call it azotemia ????

[@rahulranganathan107]

Excellent videos bro...god bless you and fr your journey

[@spookypineapple]

You're the man.

[@lukabatrovic6009]

Dr. Patel, can you explain one thing to me. If in prerenal AKI, urine sodium is decreased, then how is osmol. od the increased? Where does osmol. comes from?

[@azharkhan-fr4vl]

Increased Osmolality doesn't always means that ions should be increased.. it is a ratio of ions(solute) dissolved in a solvent.. as there is decrease in urine sodium concentration but at the same time water absorption due to ADH ( released due to low plasma volume) is more as compared to decrease in urinary sodium.. as a result osmolality increases

[@ritumaida6913]

Keep it up .....great explanation☺

[@pavitrahegde3063]

Nicely explained, thanks!!

[@deepaksingh-ut7lh]

Keep it up bro....... Excellent Explanation

[@sameersagarsinghsonkar9716]

1st discuss what's AKI,...after that discuss further it's better to understand

[@indiandoctorsaiims173]

Too much helpful and yr acid base balance video is awesome 💪💪👌👌👌👌

[@janhaviborkar8287]

Amazing explaination 💯

[@steamergamer4249]

Why a cardiothoracic surgeon watching this 😂😂

[@nileshmane6476]

Excellent explanation sir

[@jeanner7306]

great video, thanks for posting!!!

[@raahilatheist4258]

Best expanation thanku sir plz contiue to make more videos

[@lrs1675]

If urine FeNa increases >2% in Intrinsic Renal azotemia how does osmolality decrease? I thought Urine Osmolality = 2 x (urine Na) + Urine K + (urinary urea nitrogen/2.8) + (urine glucose/18).

[@cutiecouplecheekybubble]

As in comparison of na more water is excreted into urine as water couldn't absorb as tubular epithelium is damaged

[@argumentumadbaculum]

All your videos are gems

[@dktreat9462]

very clear explanation. Keep it up

[@sarahNnazim]

dr.patel would u be kind to us and make a video on fluid electrolyte distribution, please.

[@Meetpatel-pu6me]

dr. Sarah....I would love to make new videos but because of final exams and step 2 preparation I am having difficult time making new videos....will try to resume soon after final exams...sorry for that.

[@maryammohammad2282]

Why creatinine dosent get reabsorbed in prerenal I couldn’t get it?

[@jashankparwani182]

What was your step1 score and when did you take the exam?

[@Meetpatel-pu6me]

Step 1 score - 249. I took it in 2016

[@IJAZ-o4n]

excelent lecture

[@Sunitasingh12375]

Sir please tell me all the sources needed to score high in step 1 for PHYSIOLOGY:please reply Sir things are confusing on u tube Please do reply sir

[@Meetpatel-pu6me]

B&B videos(based on reviews) , FA and UW should be enough. Supplement it with BRS Physiology if needed.

[@ridazahra2009]

Explained really well

[@medicss1836]

Much helpful then any other video

[@AbdurRahman-pn4qi]

Great job sir!!

[@muhammadmehdi5752]

amazing explanation (y)

[@davidmbeckmann]

Very good, sir!

[@oliverpapa7716]

Very clear and helpful , good explaination .

[@kholailyas820]

Best lecture

[@rebazaped1675]

Well done Dr

[@basildabbah3851]

nice man :)) can u please explain renal tubular acidodis !!!!

[@Meetpatel-pu6me]

basil dabbah thank you.... actually i am making video on whatever topic i am prepared with and fortunately i am doing RTA so video will be ready in few hours..cheers !

[@basildabbah3851]

thanks doc much appreciate

[@aleezasyed935]

it realy helped me awesome 👌👌

[@shkooling]

Thank you for the video! I liked the video! I still have some confusion and am hoping someone can help me. So with intrinsic AKI, the tubular epithelium is damaged, so they can not reabsorb things back into the blood. I still don't understand why BUN and Cr are building up in the blood? Is it because in intrinsic AKI it can't get filtered as well?? Any help would be appreciated thank you!

[@shridhardodamani7752]

Filtration is affected in all the three causing azotemia . Thats why we talk in ratios to differentiate the three

[@tranminhnghia5498]

I don't know if you still require answer to this question, what I understand is: - Prerenal AKI makes GFR drops because of lack of blood flow. - Intrinsic AKI makes GFR drops because of direct damage, like inflammation, ischemia, which affects both the tubules (reabsorption and concentration) and the glomeruli (filtration). - Post renal AKI, I assume, in the early stage does not drop GFR, but later the built up fluid damages the glomeruli and tubules, leading to the same issues as intrinsic AKI. All three got problems with excreting BUN and creatinine and various azote byproducts either because of compromised glomeruli function or reduced kidney blood flow (which might in turn creates glomeruli damage). So how do we distinguish them? - Prerenal AKI got distinctively high BUN/creatinine ratio (in blood) > 20 from the start, and maintained tubular function (urine osmolality > 500), and raised ADH, aldosterone (effort to raise renal blood flow) (Fe Na < 1% and urine Na < 20). - Intrinsic AKI got low BUN/creatinine ratio < 15 all the way (BUN got lost via GI tract and skin, creatinine got no other exits), disrupted tubular function all the way so no concentration, no Na reabsorption (urine osmolality < 350, urine Na > 40, Fe Na > 2%). - Post renal AKI got BUN/creatinine ratio that is > 15 early because maintained tubular function + increase hydrostatic pressure in the tubules making BUN reabsorption increases (creatinine remains unabsorbed), then BUN/creatinine ratio drops < 15 when tubular damage occurs. Since we can still properly filter fluid and have no need to increase blood flow, aldosterone and ADH do not rise, leading to urine Na > 40 and Fe Na > 1% or 2%; tubular damage might play a role as in intrinsic AKI, in not reabsorbing Na properly.

[@dr.tajuddinansari3773]

Nice explaination.....

[@vinothshanmugam9369]

Thank u for this explanation

[@miramira3492]

thank you so much its so helpful

[@dracm8618]

Gud work machaa

[@RahulTiwari-xz5pj]

great job brother.:) thanks

[@Meetpatel-pu6me]

Rahul Tiwari thank you bro :)

[@ellefer24_9]

excellently explained...

[@Meetpatel-pu6me]

thank you :))

[@977vet]

Good job. Thanks

[@soniyaabraham6465]

good work

[@hebamohamad9197]

Thank you 💙👏👏

[@HH-nd2vq]

Thank you so much

[@Ray-rm1mk]

Thank you !

[@zaralatiefwani599]

thankyou:) this was useful

[@Meetpatel-pu6me]

zara you are welcome :))

[@gaurabjungkc6545]

great!

[@Gb-vc8de]

Thanks you sir

[@sumilemontree4771]

very nice

[@rosemanalodil]

Thanks 🙏🏼

[@thanveerahamedkp]

awesome

[@lifeintinysquares3317]

❤

[@drtonyissac9297]

Thank u bro

[@priyadarshivishal237]

Kindly upload more content

[@Meetpatel-pu6me]

Sure. Will give my best

[@naveedalam685]

thank u

[@fazzaah]

nice pencil

[@Meetpatel-pu6me]

sha A haha

[@loly5113]

Niiiice👍👍👍👍😭

[@samyan_saleem4252]

Thnx:)

[@Ahsaas]

English ki Kya zarort hai Hindi mai paraw😡😡

[@eshallkhan3298]

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[@DYShah-ow9zn]

👍👌

[@Meetpatel-pu6me]

D. Y. Shah thank you :))

[@VS-xc2iv]

So easily made for us

[@Alexandra-us2om]

Thank you 🙏🏻

[@hanosha1323]

Amazing

[@subhashkumar-qj2vf]

Thank you