Acute Kidney Injury (AKI) Quiz

Acute Kidney Injury (AKI)

• Definition: sudden decrease in kidney function, resulting in accumulation of waste products in the blood
• Causes:
  • Prerenal: decreased blood flow to kidneys (e.g. hypovolemia, shock)
  • Intrinsic: damage to kidneys themselves (e.g. toxins, sepsis)
  • Postrenal: obstruction of urine flow (e.g. kidney stones, tumor)
• Stages:
  1. Risk: early stages of AKI, can be reversible
  2. Injury: established AKI, may progress to failure
  3. Failure: severe AKI, requires dialysis
  4. Loss: complete loss of kidney function
  5. End-stage: irreversible kidney damage, requires chronic dialysis
• Clinical features:
  • Oliguria (decreased urine output)
  • Azotemia (elevated blood urea nitrogen)
  • Electrolyte imbalance
  • Fluid overload

Chronic Kidney Disease (CKD)

• Definition: gradual loss of kidney function over time
• Stages:
  1. Stage 1: kidney damage with normal or increased GFR
  2. Stage 2: mild decrease in GFR
  3. Stage 3: moderate decrease in GFR
  4. Stage 4: severe decrease in GFR
  5. Stage 5: end-stage kidney disease, requires dialysis
• Causes:
  • Diabetes
  • Hypertension
  • Glomerulonephritis
  • Polycystic kidney disease
• Clinical features:
  • Nephrotic syndrome (see below)
  • Hypertension
  • Anemia
  • Bone disease

Nephrotic Syndrome

• Definition: group of symptoms due to damage to glomeruli, resulting in excessive protein loss in urine
• Clinical features:
  • Proteinuria (excessive protein in urine)
  • Hypoalbuminemia (low albumin levels)
  • Edema (swelling)
  • Hyperlipidemia (high cholesterol)
• Causes:
  • Glomerulonephritis
  • Diabetes
  • Systemic lupus erythematosus
  • Amyloidosis

Glomerulonephritis

• Definition: inflammation of glomeruli, resulting in damage to kidney function
• Types:
  • Acute: sudden onset, often reversible
  • Chronic: gradual onset, often irreversible
• Causes:
  • Post-infectious (e.g. strep throat)
  • Immune complex-mediated (e.g. lupus)
  • Pauci-immune (e.g. vasculitis)
• Clinical features:
  • Hematuria (blood in urine)
  • Proteinuria
  • Hypertension
  • Edema

Renal Hypertension

• Definition: high blood pressure caused by kidney disease
• Causes:
  • Renal artery stenosis
  • Chronic kidney disease
  • Glomerulonephritis
  • Renal parenchymal disease
• Clinical features:
  • Hypertension
  • Kidney damage
  • Fluid retention
  • Electrolyte imbalance
• Treatment:
  • Medications to control blood pressure
  • Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) to slow kidney damage

Acute Kidney Injury (AKI)

• Sudden decrease in kidney function, resulting in waste product accumulation in the blood
• Causes: decreased blood flow to kidneys, damage to kidneys themselves, or obstruction of urine flow
• Three main categories of causes: prerenal, intrinsic, and postrenal
• Prerenal causes: hypovolemia, shock, and decreased blood flow
• Intrinsic causes: toxins, sepsis, and damage to kidneys
• Postrenal causes: kidney stones, tumors, and obstruction of urine flow

Stages of AKI

• Risk: early stages, reversible, and may progress to injury
• Injury: established AKI, may progress to failure
• Failure: severe AKI, requires dialysis
• Loss: complete loss of kidney function, often irreversible
• End-stage: irreversible kidney damage, requires chronic dialysis

Clinical Features of AKI

• Oliguria: decreased urine output
• Azotemia: elevated blood urea nitrogen
• Electrolyte imbalance: altered levels of essential minerals
• Fluid overload: excessive fluid accumulation in the body

Chronic Kidney Disease (CKD)

• Gradual loss of kidney function over time
• Five stages based on glomerular filtration rate (GFR)
• Stage 1: kidney damage with normal or increased GFR
• Stage 2: mild decrease in GFR
• Stage 3: moderate decrease in GFR
• Stage 4: severe decrease in GFR
• Stage 5: end-stage kidney disease, requires dialysis

Causes of CKD

• Diabetes: high blood sugar levels damaging kidneys
• Hypertension: high blood pressure damaging kidneys
• Glomerulonephritis: inflammation of glomeruli
• Polycystic kidney disease: genetic disorder causing cysts on kidneys

Clinical Features of CKD

• Nephrotic syndrome: group of symptoms due to glomerular damage
• Hypertension: high blood pressure
• Anemia: decreased red blood cell count
• Bone disease: abnormalities in bone structure and function

Nephrotic Syndrome

• Group of symptoms due to glomerular damage, resulting in excessive protein loss in urine
• Clinical features: proteinuria, hypoalbuminemia, edema, and hyperlipidemia
• Causes: glomerulonephritis, diabetes, systemic lupus erythematosus, and amyloidosis

Glomerulonephritis

• Inflammation of glomeruli, resulting in damage to kidney function
• Two main types: acute and chronic
• Acute: sudden onset, often reversible
• Chronic: gradual onset, often irreversible
• Causes: post-infectious, immune complex-mediated, and pauci-immune
• Clinical features: hematuria, proteinuria, hypertension, and edema

Renal Hypertension

• High blood pressure caused by kidney disease
• Causes: renal artery stenosis, chronic kidney disease, glomerulonephritis, and renal parenchymal disease
• Clinical features: hypertension, kidney damage, fluid retention, and electrolyte imbalance
• Treatment: medications to control blood pressure, ACEIs or ARBs to slow kidney damage