View ; Guiteras, R.; Dolad, N.; Rubio-Soto, I.; Manonelles, A.; Codina, S.; Ortiz, A.; et al. 2023. Interpretation of urine electrolytes is limited because it is a single measure in time, and the results are confounded by acute volume changes. 0430. situation you are calling Our results suggest that the higher levels of antioxidant mRNA, and higher expression of FOXO3, without the increased expression of BAX, despite the lack of regulation by Sirtuin 1, reflect the optimized antioxidant response in the KOSA3+IR group. In Japan, vadadustat is approved as a treatment for anemia due to CKD in both dialysis-dependent and non-dialysis dependent adult patients. Use a sterile technique to change the dressing. those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). If its not controlled or treated in the early onset, complications can arise. An integrative view of serpins in health and disease: The contribution of SerpinA3. ; Govil, D.; et al. 3. ECG indicates atrial fibrillation; he is placed on telemetry. The antioxidant protection observed was associated with diminished pro-apoptotic signaling. Nurse Sam is assessing Ms. Swisher's AV fistula prior to hemodialysis. Which of the following information from the EMR is the priority for Nurse Chris to report? This type of kidney damage is usually . Chamberlain College of Nursing. The data that support the findings of this study are available on request from the corresponding author (NAB). R: My recommendation would be change the dressing, monitor labs and vitals constantly, possibly prescribe something for nicotine withdrawl. PloS one, 11(7), e0159335. Atrial fibrillation. ATI Real Life 2.0: Kidney disease Scenario Tutorial: Real Life RN Medical Surgical 2.0 Module: Kidney Disease 1. Got questions about kidney failure or dialysis? Score damage was evaluated according to McLarnon, SR et al. Other diagnostic studies conducted to diagnose this condition include renal ultrasound, CT scan, and biopsy. Administer fluids with caution.Fluid therapy can help with promoting urinary elimination but can cause worsening fluid retention and electrolyte imbalances. This study was supported by grants from the Mexican Council of Science and Technology (CONACyT) (A1-S-8715 to NAB) and from the Universidad Nacional Autnoma de Mxico (IN201619 and IN201022 to NAB). Aerodynamic force and torque measurements were conducted for six wing planforms (with aspect ratios of 2 and 3, and area centroid locations at 40%, 50%, and 60% of the wing length) at three different Reynolds numbers (0.5 × 104, 1 × 104, and 1.5 × 104) and . Benzinga does not provide investment advice. A move from care in hospitals to the community 4. We observed a remarkable change in the UH, It has been reported that the deacetylase Sirtuin-1 is a stress-responsive protein that protects against ROS in mice with AKI, attenuating the damage of renal cells. binders, skin care, pulmonary Zhou, T.; Zong, R.; Zhang, Z.; Zhu, C.; Pan, F.; Xiao, X.; Liu, Z.; He, H.; Ma, J.-X. University Samuel Merritt University. Administer loop diuretics.Loop diuretics are potassium-wasting and will rid the body of potassium. All experiments involving animals were conducted in strict accordance with the NIH Guide for the Care and Use of Laboratory Animals and with the Mexican Federal Regulation for animal reproduction, care, and experimentation (NOM-062-ZOO-2001). A single nephron model of acute tubular injury: Role of tubuloglomerular feedback. BP 132/. Our results show that the attenuation in renal dysfunction after I/R observed in the KOSA3+IR group seems to be mediated by a better response against renal hypoxia. Nurse Allyson. https://www.prnewswire.com/news-releases/akebia-receives-european-commission-approval-for-vafseo-vadadustat-for-the-treatment-of-symptomatic-anaemia-associated-with-chronic-kidney-disease-in-adults-on-chronic-maintenance-dialysis-301807286.html, Do Not Sell My Personal Data/Privacy Policy. About Akebia TherapeuticsAkebia Therapeutics, Inc. is a fully integrated biopharmaceutical company with the purpose to better the lives of people impacted by kidney disease. Further studies are required to address the relevance of SerpinA3K deficiency in different pathological settings, including CKD, diabetic nephropathy, and even immune-mediated nephritis. A. use a 3mL syringe for admin of IV meds. showing signs of fluid overload. Nephrology consultation should be considered when there is inadequate response to supportive treatment and for acute kidney injury without a clear cause, stage 3 or higher acute kidney injury, preexisting stage 4 or higher chronic kidney disease, renal replacement therapy, and other situations requiring subspecialist expertise. SerpinA3 has been identified as a specific inhibitor of tissue kallikrein and named kallikrein-binding protein, which is expressed in the liver, pancreas, kidney, cornea, and skin. Sanchez-Navarro, A.; Gonzlez-Soria, I.; Caldio-Bohn, R.; Bobadilla, N.A. When there is excess fluid, complications can arise including swelling, hypertension, and heart problems. A fractional excretion of urea less than 35% suggests a prerenal cause, whereas a value greater than 50% suggests an intrinsic cause. -Food security MR. Jones was recently discharged from another facility for treatment for his atrial fibrillation and a, type 2 diabetic ulcer on his right foot. muscle weakness, Immune complexes from systemic illness (e.g., membranoproliferative glomerulonephritis, polyarteritis nodosa) cause acute inflammation and structural damage to the glomeruli. kidney disease, monitor I/O, fluid In addition, to the histopathological findings, urinary biomarkers of AKI were assessed. No. Patients with CRF are at risk of developing electrolyte imbalance due to impaired kidney function. Find support for a specific problem in the support section of our website. https://doi.org/10.3390/ijms24097815, Gonzlez-Soria, Isaac, Axel D. Soto-Valadez, Miguel Angel Martnez-Rojas, Juan Antonio Ortega-Trejo, Rosalba Prez-Villalva, Gerardo Gamba, Andrea Snchez-Navarro, and Norma A. Bobadilla. Protocol-based strategies are recommended to prevent and improve acute kidney injury in high-risk patients (e.g., those who are postoperative or in septic shock).7 A randomized controlled trial (RCT) of 776 patients with septic shock compared outcomes with a mean arterial pressure goal of 65 to 70 mm Hg vs. a goal of 80 to 85 mm Hg. does he/she want? es, diuretics, No. GI Bleed is defined as any bleeding that occurs within the gastrointestinal tract. The following risk factors increase the incidence of CRF: CRF is categorized into stages based on the patients glomerular filtration rate (GFR): The clinical manifestations of CRF often occur due to retained creatinine, urea, phenols, electrolytes, and water and can vary depending on the severity. Restrict intake when levels are high or provide additional sources if deficient. Gonzlez-Soria, I.; Soto-Valadez, A.D.; Martnez-Rojas, M.A. Assess lung sounds.Adventitious lung sounds such as rales or crackles and dyspnea signal a complication of fluid retention. Based upon Home Health Nurse Ariel's notes in the EMR, what total score should be documented in the assessment tool regarding Ms. Swisher's peritoneal site? Wei, W.; Ma, N.; Fan, X.; Yu, Q.; Ci, X. Real Life 3.0 Scenario PN Medical Surgical: Kidney Disease Notes - Real Chest Xray revealed right lung opacities greater than left lung, Last set of vitals are pulse 140 irregular, RR 32, 85% 3L NC, shock, severe burns, liver failure, Severity of acute kidney injury is classified according to urine output and elevations in creatinine level. Urinary hydrogen peroxide concentration was measured by using a commercial kit (Amplex Red Hydrogen Peroxide/Peroxidase Assay, cat. GI Bleed can be caused by a variety of factors, including ulcers, tumors, inflammation, and trauma. . To begin to understand the role of SerpinA3K on AKI, SerpinA3K-deficient (KOSA3) mice were studied 24 h after inducing ischemia/reperfusion (I/R) and compared to wild type (WT) mice. In the case of AKI to CKD transition, the abnormal presence of SerpinA3K in urine preceded the increase in serum creatinine, urinary protein excretion, and kidney fibrosis. Which of the following interventions should Nurse Chris implement based upon Ms. Swisher's current laboratory results? ; Colman, R.; Cruz, D.N. Use of periprocedural normal saline and minimizing the volume of contrast media reduce the risk of contrast mediainduced acute kidney injury.49 Sodium bicarbonatebased intravenous fluids are not superior to normal saline in preventing acute kidney injury.50, A meta-analysis of 15 RCTs (n = 6,532) showed that in patients undergoing coronary angiography or percutaneous coronary intervention, high-dose statins (e.g., atorvastatin [Lipitor], rosuvastatin [Crestor], simvastatin [Zocor]) reduced the incidence of contrast mediainduced acute kidney injury when compared with low-dose statins or placebo (ARR = 2.8%; NNT = 36).51 A Cochrane review of 72 studies (n = 4,378) found no convincing evidence that any pharmacologic intervention reduces the risk of acute kidney injury during the perioperative period.52, This article updates previous articles on this topic by Rahman, et al.13 ; Needham53 ; and Agrawal and Swartz.54. 2021.06.03 07:19 Bebebaubles Tarlovcyst. Patients with CRF are often asymptomatic and early symptoms may not be recognized. Pharmacist-led quality improvement initiatives. Which of the following interventions should Nurse Chris include? This appears to be mediated by an early upregulation of HIF-1 and sustained regulation of antioxidant enzymes, which could be promoted by a higher initial expression of intrarenal FOXO3. Nurse Sam recognizes that Ms. Swisher's emotional state might also be related to physiological findings and is reviewing Ms. Swisher's EMR. __________________________________________________________, Active Learning Template medication Anticholinergic, Care of the childrearing family (nurs420), Biology: Basic Concepts And Biodiversity (BIOL 110), Introduction to Interpersonal Communications ( COMM 102), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Lesson 12 Seismicity in North America The New Madrid Earthquakes of 1811-1812, CH 13 - Summary Maternity and Pediatric Nursing, Module One Short Answer - Information Literacy, Is sammy alive - in class assignment worth points, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, The cell Anatomy and division. IV fluids, and labs, Lab results: provide background information urine volume, color, specific gravity, ; supervision, N.A.B. like his heart is pounding. SERPINA3K prevents oxidative stress induced necrotic cell death by inhibiting calcium overload. ; Hou, Y.-P.; Li, B. Hypoxia-inducible factor protects against acute kidney injury via the Wnt/b-catenin signaling pathway. supplement, All Rights Reserved. Select the image that correctly displays the pattern in which the leads should be applied. Nurse Chris should identify that which if the following findings indicates the effectiveness of furosemide? Renal injury was evaluated 24 h after bilateral renal ischemia, as is shown in. ; Zhang, M.-Z. All articles published by MDPI are made immediately available worldwide under an open access license. The overexpression and urinary excretion of SerpinA3K in animals and patients with AKI and CKD suggest that this protein may have an active role during kidney damage. A risk diagnosis is not evidenced by any signs and symptoms, as the problem has not occurred yet and nursing interventions will be directed at the prevention of symptoms. ATI: RN Adult Medical Surgical Kidney Disease of excretion, Primary HCP, nursing, General management principles for acute kidney injury include determination of volume status, fluid resuscitation with isotonic crystalloid, treatment of volume overload with diuretics, discontinuation of nephrotoxic medications, and adjustment of prescribed drugs according to renal function. J. Mol. ; Zhou, K.; Chen, Y.; Hu, Y.; Zhou, T.; He, X.; Ma, J.-X. Influence of tissue perfusion on the outcome of high-risk surgical patients needing blood transfusion. 2011.06.30 13:21 pwndcake Kidney failure. Nurses are responsible for encouraging health promotion activities that can delay and prevent the onset of CRF. If AKI is treated early, most people will return to their previous . 1996-2023 MDPI (Basel, Switzerland) unless otherwise stated. ATI template. DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________, Pathophysiology Related MICHAEL G. MERCADO, MD, DUSTIN K. SMITH, DO, AND ESTHER L. GUARD, DO. One limitation of this study is that it was not designed to assess the long-term consequences of AKI but only the short-term ones, such as 24 h after I/R. The kidneys activate mechanisms to compensate for the reduced renal perfusion in an attempt to maintain the GFR.14 However, patients with impairment to these mechanisms, such as those with chronic kidney disease, have an elevated risk of acute kidney injury.3. Exam (elaborations) - Ati learning systems rn medical-surgical: cardiovascular and . methods, instructions or products referred to in the content. CRF is categorized into stages based on the patient's glomerular filtration rate (GFR): Stage 1. The optical density was measured with ImageJ. https://www.mdcalc.com/fractional-excretion-sodium-fena, https://www.mdcalc.com/fractional-excretion-urea-feurea, https://www.mdcalc.com/mean-arterial-pressure-map, Consistent evidence from RCTs showing no clear renal or mortality benefit of colloids over isotonic crystalloids, Evidence from cohort studies and a limited number of RCTs showing improved mortality and decreased need for renal replacement therapy, Evidence from a limited number of cohort studies showing improvements in hospital mortality and acute kidney injury progression, Consistent evidence from multiple RCTs and meta-analysis, Hemorrhage, gastrointestinal losses, renal losses, skin and mucous membrane losses, nephrotic syndrome, cirrhosis, capillary leak, Sepsis, cirrhosis, anaphylaxis, pharmacologic adverse effects, Cardiogenic shock, pericardial diseases, congestive heart failure, valvular diseases, pulmonary diseases, sepsis, Early sepsis, hepatorenal syndrome, acute hypercalcemia, pharmacologic adverse effects, iodinated contrast media, Hematologic disorders: hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, Inflammation: antiglomerular basement membrane disease, antineutrophil cytoplasmic antibody disease, infection, cryoglobulinemia, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, systemic lupus erythematosus, Henoch-Schnlein purpura, polyarteritis nodosa, Malignant hypertension, toxemia of pregnancy, hypercalcemia, radiocontrast media, scleroderma, pharmacologic adverse effects, Endogenous toxins: myoglobin, hemoglobin, paraproteinemia, uric acid, Exogenous toxins: antibiotics, chemotherapy agents, radiocontrast media, phosphate preparations, Vascular causes (e.g., large vessel diseases, such as renal artery thrombosis; embolism; stenosis; and operative renal arterial clamping), Arterial thrombosis, vasculitis, dissection, thromboembolism, venous thrombosis, compression, trauma, Bladder: neck obstruction, calculi, carcinoma, infection (schistosomiasis), Functional: neurogenic bladder, diabetes, multiple sclerosis, stroke, pharmacologic adverse effects (anticholinergics, antidepressants), Prostate: benign prostatic hypertrophy, carcinoma, infection, Urethral: posterior urethral valves, strictures, trauma, infections, tuberculosis, tumors, Retroperitoneal space tumors, pelvic or intra-abdominal tumors, retroperitoneal fibrosis, ureteral ligation or surgical trauma, granulomatous disease, hematoma, Nephrolithiasis, strictures, edema, debris, blood clots, sloughed papillae, fungal ball, malignancy, Acute or chronic tubulointerstitial injury, Leukocyturia, renal tubular epithelial cells, white blood cell casts, and granular casts, Drug-induced or endogenous crystalline nephropathy, Urinary acanthocytes and red blood cell casts, Renal tubular epithelial cells, renal tubular epithelial cell casts, and muddy brown casts, NSAIDs (ibuprofen, naproxen, ketorolac, celecoxib), ACEi (captopril, lisinopril, benazepril, ramipril), ARB (losartan, valsartan, candesartan, irbesartan), Analgesics (morphine, meperidine, gabapentin, pregabalin), Antivirals (acyclovir, ganciclovir, valganciclovir), Antimicrobials (almost all antimicrobials need dose adjustment in AKI, with important exceptions of azithromycin, ceftriaxone, doxycycline, linezolid, moxifloxacin, nafcillin, rifampin), Diabetic agents (sulfonylureas, metformin), Potassium level > 6.5 mEq per L (6.5 mmol per L), Urea nitrogen concentrations > 84 mg per dL (30 mmol per L), pH < 7.2 despite normal or low partial pressure of carbon dioxide in arterial blood, Pulmonary edema unresponsive to diuretics. arrhythmias, toxin Ischemic causes include prolonged periods of severe hypotension, hypovolemia, or hypoperfusion to the kidneys (e.g., from hemorrhage, shock, sepsis, cirrhosis, peritonitis, or infarcts) that do not improve with rehydration.11 Nephrotoxic causes include endogenous and exogenous toxins. Copyright 2023 American Academy of Family Physicians. ; Lameire, N.; Aspelin, P.; Barsoum, R.S. The discrepancy in the regulation of Sirtuin 1 and FOXO3 on PGC-1 and BAX could be explained by the timing of when these proteins were studied, which was only 24 h after the I/R. 2. Experimental models of acute kidney injury for translational research. 1. (review sheet 4), 1-3 Discussion- Population, Samples, and Bias, Burn Sheet Music Hamilton (Sheet Music Free, Wong s Essentials of Pediatric Nursing 11th Edition Hockenberry Rodgers Wilson Test Bank, Gizmos Student Exploration: Effect of Environment on New Life Form, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. Home Health Nurse Ariel and Ms. Swisher are discussing some of the ingredients contained in some of her favorite recipes that would align with her prescribed diet. Nurse Allyson is preparing to perform a sterile . Martnez-Rojas, M.; Snchez-Navarro, A.; Meja-Vilet, J.M. ; Prez-Villalva, R.; Uribe, N.; Bobadilla, N.A. A fractional excretion of sodium less than 1% suggests a prerenal cause of acute kidney injury, whereas a value greater than 2% suggests an intrinsic cause. Reverse transcription was performed to obtain cDNA. Moderate decrease in GFR (rate between 30-44) Prepare the patient for dialysis as indicated.Patients with stage 5 renal failure will require dialysis. Khan, Y. H., Sarriff, A., Adnan, A. S., Khan, A. H., & Mallhi, T. H. (2016). permission provided that the original article is clearly cited. ; Sander, V.; Perreau, T.; Starr, M.C. 554480-1-AO), anti-SIRT1 (1:1500; Santa Cruz, Cat. A decrease of greater than 33% in the first 12 hours conferred a twofold elevated risk of dialysis or death.20, Urinalysis in combination with urine microscopy provides insight into the location and cause of acute kidney injury. Sci. 1. PDF Type 1 Diabetes (T1D) is a chronic disease caused by autoimmune Real Life Clinical Reasoning Scenarios | ATI After treatment, he is transferring to the telemetry unit.B - Background60 year old African-American male with a history of peripheral vascular disease, type 2 diabetes, chronic kidney. ; Peng, Z. Mitochondria ROS and mitophagy in acute kidney injury. Excess fluid volume is common in patients with CRF because the kidneys are not functioning to remove excess fluids and waste products from the body. Real Life 3.0 Scenario PN Medical Surgical: Kidney Disease With Complete Solutions Exam (elaborations) 16 pages 2022 Real Life 3.0 Scenario PN Medical Surgical: Kidney Disease With Complete Solutions (0) $13.49 1x sold + learn more Sell your knowledge on Stuvia Hundred thousands of people are searching for your content every day. nephrology, dietitian, No. Snchez-Navarro, A.; Murillo-De-Ozores, A.R. The molecular weight is around 4655 kD. Acute kidney injury (AKI) is a sudden decline in the ability of your kidneys to work and perform their normal functions. Regulated necrosis in kidney ischemia-reperfusion injury. showing signs and symptoms of poor perfusion. Wang, Y.; Zhou, Y.; Graves, D.T. A rapidly evolving healthcare system 2. 2. Nurse Chris is planning care based on Ms. Swisher's most recent laboratory results. Anti-inflammatory and antioxidant effects of SERPINA3K in the retina. The severity of the bleeding can vary from mild to severe and can be life-threatening in . In addition, the questions listed below must be answered. Urinary biomarkers were evaluated as we described before [. The approval follows the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) positive opinion issued in February 2023 recommending the EC approve Vafseo. ; Liu, Z.; et al. Acute kidney injury (AKI) | American Kidney Fund . Fluid restriction is indicated to prevent and reduce fluid overload. Before we get into the disease itself, let's talk a little bit about the kidneys and what they do. Int. In spite of severe renal injury induced by 30 min of I/R, the initial molecular response in the absence of SerpinA3K was different than in WT mice. PDF Ati Real Life Scenario Answers Renal 4. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Give Me Liberty! imbalances can related to the situation when it happened or most exciting work published in the various research areas of the journal. Intrinsic renal causes of acute kidney injury are categorized by the location of the injury, most commonly the glomerulus or tubule, and include the interstitial or vascular portions of the kidney.11 Intrinsic acute kidney injury requires early identification and prompt subspecialty consultation. NR325 ATI Real Life 2.0 Kidney disease Scenario 12312019.docx canvas for faculty feedback. Feel free to join. Vadadustat also achieved the primary safety endpoint of the INNO2VATE program, defined as non-inferiority of vadadustat versus darbepoetin alfa in time to first occurrence of major adverse cardiovascular events, which is the composite of all-cause mortality, non-fatal myocardial infarction, or non-fatal stroke across both INNO2VATE studies. See further details. Nurse Chris is preparing to administer furosemide IV bolus for Ms. Swisher. Asthma can be broken down into two groups foundation up the causes of an attacked: extrinsic . Seagull Edition, ISBN 9780393614176, EMT Basic Final Exam Study Guide - Google Docs, Wong s Essentials of Pediatric Nursing 11th Edition Hockenberry Rodgers Wilson Test Bank, Tina Jones Heent Interview Completed Shadow Health 1, Lab 3 Measurement Measuring Volume SE (Auto Recovered), Test Out Lab Sim 2.2.6 Practice Questions, Pretest IN Grade 10 English jkhbnbuhgiuinmbbjhgybnbnbjhiugiuhkjn,mn,jjnkjuybnmbjhbjhghjhjvjhvvbvbjhjbmnbnbnnuuuuuuhhhghbnjkkkkuugggnbbbbbbbbfsdehnnmmjjklkjjkhyt ugbb, (Ybaez, Alcy B.) Background: Pertinent No. ; methodology, I.G.-S., A.D.S.-V., J.A.O.-T., R.P.-V., A.S.-N. and M.A.M.-R.; formal analysis, I.G.-S., M.A.M.-R. and N.A.B. NR325 ATI Real Life 2.0 Kidney disease Scenario 12312019.docx. Scenarios | Real Life Clinical Reasoning Scenarios | ATI 4. Serum creatinine or urine output can be used for diagnosis of acute kidney injury, although patients who meet diagnostic criteria for both are at increased risk of mortality from renal replacement therapy and hospitalization.7,19, Creatinine clearance is a direct measure of GFR, and serial creatinine clearance testing provides a more efficient and accurate assessment of renal function than serum creatinine testing.20 Creatinine clearance can be performed in collection periods of one to 24 hours, although longer collection times increase the likelihood of errors related to inaccurate time recording and incomplete collection.6 A cohort study of 484 patients in the ICU found that four-hour creatinine clearance testing is a valid measurement of acute kidney injury (defined as an increase in serum creatinine greater than 50% in the control group or a decrease in creatinine clearance greater than 33% in the intervention group). The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Navy, U.S. Air Force, Department of Defense, or the U.S. government. labs be redrawn to ensure all electrolytes are within range, Take notes as the scenario progresses so you can create an SBAR Handoff report. ; Liu, K.D. Local Inflammatory Mediators Involved in Neuropathic Pain, The Potential of Liquid Biopsy in Detection of Endometrial Cancer Biomarkers: A Pilot Study, Circulating Soluble Urokinase Plasminogen Activator Receptor as a Predictive Indicator for COVID-19-Associated Acute Kidney Injury and Mortality: Clinical and Bioinformatics Analysis, https://www.mdpi.com/article/10.3390/ijms24097815/s1, https://creativecommons.org/licenses/by/4.0/. This study was performed in partial fulfillment of the requirements for the PhD degree; Isaac Gonzlez-Soria is a doctoral student from Plan de Estudios Combinados En Medicina (PECEM), Universidad Nacional Autnoma de Mxico (UNAM) and received a fellowship from CONACYT (1045949). multimodal educational programs delivered to clinicians, care bundles may improve acute kidney injury care. Please note that many of the page functionalities won't work as expected without javascript enabled. GR ATI system Disorder - Renal Failure - ACTIVE LEARNING - Studocu Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for
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