Podcast
Questions and Answers
What is the definition of acute kidney injury (AKI) according to the text?
What is the definition of acute kidney injury (AKI) according to the text?
- An increase in serum creatinine of 0.3 mg/dL or more in 48 hours, or serum creatinine at least 1.5 times baseline in the last seven days, or urine output less than 0.5 mg/kg/hr for at least 6 hours (correct)
- Urine output less than 0.3 mg/kg/hr for at least 6 hours
- Serum creatinine at least 2 times baseline in the last seven days
- An increase in serum creatinine of 0.5 mg/dL or more in 48 hours
Which of the following is NOT a cause of post-renal AKI mentioned in the text?
Which of the following is NOT a cause of post-renal AKI mentioned in the text?
- Urinary retention
- Obstruction from a tumor
- Urethral obstruction
- Acute tubular necrosis (correct)
What is the typical fractional excretion of sodium (FENa) in pre-renal AKI?
What is the typical fractional excretion of sodium (FENa) in pre-renal AKI?
- Less than 1 percent (correct)
- Between 1 and 2 percent
- Greater than 5 percent
- Greater than 2 percent
What is the most common cause of intrinsic renal AKI according to the text?
What is the most common cause of intrinsic renal AKI according to the text?
What is the typical fractional excretion of urea (FEUrea) in pre-renal AKI?
What is the typical fractional excretion of urea (FEUrea) in pre-renal AKI?
What is the key distinguishing feature of post-renal AKI compared to other types of AKI?
What is the key distinguishing feature of post-renal AKI compared to other types of AKI?
Which of the following medications can cause pre-renal AKI due to hypotension?
Which of the following medications can cause pre-renal AKI due to hypotension?
How is post-renal AKI typically differentiated from other types of AKI?
How is post-renal AKI typically differentiated from other types of AKI?
What is the key characteristic of the urine output in patients with acute kidney injury?
What is the key characteristic of the urine output in patients with acute kidney injury?
What is a common etiology for post-renal AKI?
What is a common etiology for post-renal AKI?
Which condition can cause ureteral obstruction leading to post-renal AKI?
Which condition can cause ureteral obstruction leading to post-renal AKI?
What can cause intrinsic renal AKI due to tubular obstruction from crystals?
What can cause intrinsic renal AKI due to tubular obstruction from crystals?
Which medication can contribute to post-renal AKI by causing urinary retention?
Which medication can contribute to post-renal AKI by causing urinary retention?
Post renal AKI is reversible in the first few days
Post renal AKI is reversible in the first few days
Acute tubular necrosis, acute interstitial nephritis and tubular obstruction from crystals can cause intrinsic renal AKI
Acute tubular necrosis, acute interstitial nephritis and tubular obstruction from crystals can cause intrinsic renal AKI
What type of AKI
What type of AKI
Which laboratory finding is indicative of acute tubular necrosis?
Which laboratory finding is indicative of acute tubular necrosis?
What is the key finding in the urine sediment of a patient with acute tubular necrosis?
What is the key finding in the urine sediment of a patient with acute tubular necrosis?
Which of the following is the primary management strategy for acute tubular necrosis?
Which of the following is the primary management strategy for acute tubular necrosis?
What is the underlying cause of acute tubular necrosis according to the text?
What is the underlying cause of acute tubular necrosis according to the text?
Which of the following is an example of a nephrotoxin that can cause acute tubular necrosis?
Which of the following is an example of a nephrotoxin that can cause acute tubular necrosis?
A patient presents with concerns of "bloody/red urine." Labs show: serum creatine kinase (CK) highly elevated at 5000. Urine dipstick is positive for heme, but without RBC’s on microscopy. What is likely?
A patient presents with concerns of "bloody/red urine." Labs show: serum creatine kinase (CK) highly elevated at 5000. Urine dipstick is positive for heme, but without RBC’s on microscopy. What is likely?
Contrast-induced nephropathy presents with a raise in serum creatinine rise usually _____ hours after contrast
Contrast-induced nephropathy presents with a raise in serum creatinine rise usually _____ hours after contrast
Which of the following is NOT a common cause of acute interstitial nephritis?
Which of the following is NOT a common cause of acute interstitial nephritis?
In acute interstitial nephritis, peripheral eosinophilia, rash, and fever may be present, EXCEPT in cases caused by:
In acute interstitial nephritis, peripheral eosinophilia, rash, and fever may be present, EXCEPT in cases caused by:
Which of the following findings in the urine is suggestive of acute interstitial nephritis?
Which of the following findings in the urine is suggestive of acute interstitial nephritis?
In the absence of improvement after withdrawing the offending medication, what is the next recommended step in the management of acute interstitial nephritis?
In the absence of improvement after withdrawing the offending medication, what is the next recommended step in the management of acute interstitial nephritis?
Which of the following is a key strategy to prevent acute kidney injury (AKI)?
Which of the following is a key strategy to prevent acute kidney injury (AKI)?
Which of the following medications should be held on the day of major procedures to help prevent AKI?
Which of the following medications should be held on the day of major procedures to help prevent AKI?
What does a high fractional excretion of sodium (FENa%) suggest in acute kidney injury?
What does a high fractional excretion of sodium (FENa%) suggest in acute kidney injury?
Which type of AKI is indicated by a low fractional excretion of sodium (FENa%)?
Which type of AKI is indicated by a low fractional excretion of sodium (FENa%)?
Which of the following is a key indication for starting renal replacement therapy (dialysis) in a patient with acute kidney injury (AKI)?
Which of the following is a key indication for starting renal replacement therapy (dialysis) in a patient with acute kidney injury (AKI)?
What is a common phenomenon that can occur after a severe acute renal insult, such as acute tubular necrosis (ATN) or relief of obstruction?
What is a common phenomenon that can occur after a severe acute renal insult, such as acute tubular necrosis (ATN) or relief of obstruction?
Which of the following laboratory tests is crucial in helping differentiate the underlying cause of acute kidney injury (AKI)?
Which of the following laboratory tests is crucial in helping differentiate the underlying cause of acute kidney injury (AKI)?
What is a key strategy in the management of acute kidney injury (AKI) according to the text?
What is a key strategy in the management of acute kidney injury (AKI) according to the text?
What is a hallmark finding for glomerular disease when conducting urine microscopy?
What is a hallmark finding for glomerular disease when conducting urine microscopy?
Which syndrome presents with hypoalbuminemia, edema, and hyperlipidemia?
Which syndrome presents with hypoalbuminemia, edema, and hyperlipidemia?
What is the distinguishing feature in nephritic syndrome that is NOT present in nephrotic syndrome?
What is the distinguishing feature in nephritic syndrome that is NOT present in nephrotic syndrome?
Which condition is considered a nephrologic emergency that can lead to advanced kidney disease in a matter of weeks to months?
Which condition is considered a nephrologic emergency that can lead to advanced kidney disease in a matter of weeks to months?
What is a common risk associated with glomerular disease other than kidney-related complications?
What is a common risk associated with glomerular disease other than kidney-related complications?
A hallmark finding associated with Rapidly progessive glomerulonephritis (RPGN)is:
A hallmark finding associated with Rapidly progessive glomerulonephritis (RPGN)is:
Which type of nephrotic syndrome is the most common primary form in adults in the United States?
Which type of nephrotic syndrome is the most common primary form in adults in the United States?
Which of the following is a common characteristic of the clinical presentation of focal segmental glomerulosclerosis (FSGS)?
Which of the following is a common characteristic of the clinical presentation of focal segmental glomerulosclerosis (FSGS)?
What is the primary treatment approach for focal segmental glomerulosclerosis (FSGS)?
What is the primary treatment approach for focal segmental glomerulosclerosis (FSGS)?
What is the most common cause of secondary nephrotic syndrome, the most common glomerulopathy, as well as the most common cause of end-stage kidney disease in the United States?
What is the most common cause of secondary nephrotic syndrome, the most common glomerulopathy, as well as the most common cause of end-stage kidney disease in the United States?
What is the most common cause of primary nephrotic syndrome in children according to the text?
What is the most common cause of primary nephrotic syndrome in children according to the text?
What is a key difference in the presentation of patients with nephrotic syndrome compared to nephritic syndrome?
What is a key difference in the presentation of patients with nephrotic syndrome compared to nephritic syndrome?
Which glomerular condition is treated with immunosuppression therapy like steroids and calcineurin inhibitors?
Which glomerular condition is treated with immunosuppression therapy like steroids and calcineurin inhibitors?
What is the primary nephrotic syndrome in adults in the United States?
What is the primary nephrotic syndrome in adults in the United States?
Which glomerular disease presents with thick capillary walls and antibodies to Phospholipase A2 receptors?
Which glomerular disease presents with thick capillary walls and antibodies to Phospholipase A2 receptors?
Which glomerular condition is most common in children as the primary cause of nephrotic syndrome?
Which glomerular condition is most common in children as the primary cause of nephrotic syndrome?
What symptom is commonly observed in patients with nephritic syndrome but not in those with nephrotic syndrome?
What symptom is commonly observed in patients with nephritic syndrome but not in those with nephrotic syndrome?
What is a hallmark finding associated with Rapidly Progressive Glomerulonephritis (RPGN)?
What is a hallmark finding associated with Rapidly Progressive Glomerulonephritis (RPGN)?
What is a common presentation seen in patients with Focal Segmental Glomerulosclerosis (FSGS)?
What is a common presentation seen in patients with Focal Segmental Glomerulosclerosis (FSGS)?
Which of the following is a common secondary cause of Membranous Nephropathy?
Which of the following is a common secondary cause of Membranous Nephropathy?
How is FSGS typically treated?
How is FSGS typically treated?
What is a significant risk factor for renal vein thrombosis in patients with Membranous Nephropathy?
What is a significant risk factor for renal vein thrombosis in patients with Membranous Nephropathy?
Which glomerular condition can be due to a genetic predisposition, idiopathic, or secondary to another cause?
Which glomerular condition can be due to a genetic predisposition, idiopathic, or secondary to another cause?
Which ethnic group has a higher risk of developing diabetic nephropathy?
Which ethnic group has a higher risk of developing diabetic nephropathy?
What is the first recognizable abnormality in diabetic nephropathy according to the text?
What is the first recognizable abnormality in diabetic nephropathy according to the text?
What is the typical presentation of diabetic neuropathy according to the text?
What is the typical presentation of diabetic neuropathy according to the text?
What is the primary treatment for diabetic nephropathy?
What is the primary treatment for diabetic nephropathy?
Which type of glomerulonephritis is often ANCA-positive according to the text?
Which type of glomerulonephritis is often ANCA-positive according to the text?
Which type of glomerulonephritis is described as a chronic condition with a low progression rate in the text?
Which type of glomerulonephritis is described as a chronic condition with a low progression rate in the text?
Which type of glomerulonephritis is most common 1-6 weeks after a streptococcal infection?
Which type of glomerulonephritis is most common 1-6 weeks after a streptococcal infection?
Which glomerular disease is common in Asian and Northern European populations according to the text?
Which glomerular disease is common in Asian and Northern European populations according to the text?
Study Notes
Acute Kidney Injury (AKI)
- Defined as an increase in serum creatinine of 0.3mg/dL or more in 48 hours, or serum creatinine at least 1.5 times baseline in the last seven days, or urine output less than 0.5 mg/kg/hr for at least 6 hours (oliguria)
- Associated with increased mortality independent of the cause of injury
- Presents with oliguria (less than 500 ml of urine per day in adults), and symptoms that are due to the underlying condition
- Categorized as pre-renal AKI, post-renal AKI, and intrinsic renal AKI
Post-Renal AKI
- Due to an obstruction of urine outflow
- Etiologies include urinary retention, urethral obstruction, and obstruction from a tumor
- Can be reversible in the first few days
- Can be found on ultrasound
Pre-Renal AKI
- Due to a drop in glomerular perfusion due to hypotension or hypovolemia
- Can be caused by NSAIDs, ACEi, and ARBs due to hypotension
- Characterized by a fractional excretion of sodium (FENa) usually less than 1 percent and fractional excretion of urea (FEUrea) usually greater than 35 percent
Intrinsic Renal AKI
- Commonly due to glomerular disease, specifically rapidly progressive glomerulonephritis
- Can also be caused by acute tubular necrosis, acute interstitial nephritis, and tubular obstruction from crystals
Acute Tubular Necrosis (ATN)
- Death of the kidney tubules due to either ischemia or nephrotoxins
- Nephrotoxins that can cause ATN include iodinated contrast
- Lab findings include FENa greater than 2 percent and FEUrea greater than 35 percent
- Characterized by the presence of "muddy brown pigmented, coarse granular casts" in the urine sediment
- Managed with supportive care and preserving volume status while the tubules regenerate
Acute Interstitial Nephritis
- Caused by hypersensitivity to a medication, autoimmune causes, infectious causes, infiltrative disease, and toxins
- May present with peripheral eosinophilia, pruritic rash, and/or fever
- Usually diagnosed presumptively and treated by withdrawing the offending medication
Prevention of AKI
- Maintain adequate volume and blood pressure
- Minimize exposure to ionic contrast
- Hold ACEi's/ARB's and diuretics on the day of major procedures
- Avoid NSAID's in high-risk patients
- Use caution with nephrotoxic drugs in general
Glomerular Disease
- Characterized by proteinuria (specifically albuminuria)
- Red blood cell casts and/or dysmorphic red blood cells are often present in urine microscopy due to damaged glomerulus
- Hallmark findings include tea-colored urine due to large amounts of hematuria
- Nephrotic syndrome presents with hypoalbuminemia, edema, hyperlipidemia, lipiduria
- Nephritic syndrome presents with hematuria with dysmorphic red blood cells, hypertension, and azotemia
- Rapidly progressive glomerulonephritis (RPGN) is a nephrologic emergency that can result in advanced CKD or end-stage kidney disease in weeks to months
- Hallmark finding associated with RPGN is "glomerular crescents" on biopsy
Nephrology
- A medical subspecialty dealing with renal disorders and diseases
- Focuses on maintaining the normal function of kidneys or restoring their function when damaged
- Nephrologists diagnose and treat kidney diseases, electrolyte disorders, glomerular disease, renal transplantation, dialysis, hypertension, diabetes, and other related conditions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on the criteria used to define acute kidney injury (AKI) and the risk factors associated with it. Learn about the key indicators such as serum creatinine levels and urine output that signify AKI.
