Acute Kidney Injury Overview
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Questions and Answers

What is the most common category of causes for Acute Kidney Injury?

  • Prerenal Causes (correct)
  • Nephrogenic Causes
  • Intrarenal Causes
  • Postrenal Causes

Which condition is NOT a prerenal cause of Acute Kidney Injury?

  • Glomerulonephritis (correct)
  • Hypovolemia
  • Low blood pressure
  • Heart failure

What can lead to acute tubular necrosis as an intrarenal cause of AKI?

  • Direct injury to kidney structures (correct)
  • Hypoperfusion of the kidneys
  • Impaired immune response
  • Urinary blockage

Which of the following is considered a postrenal cause of Acute Kidney Injury?

<p>Kidney stones (C)</p> Signup and view all the answers

What is the primary pathophysiological event associated with prerenal Acute Kidney Injury?

<p>Renal hypoperfusion (B)</p> Signup and view all the answers

What sequence of events can occur if prerenal AKI is left untreated?

<p>Progression to acute tubular necrosis (B)</p> Signup and view all the answers

Which type of injury is primarily involved in intrarenal Acute Kidney Injury?

<p>Hypoxia in renal tissue (B)</p> Signup and view all the answers

Which scenario is likely to lead to a prerenal cause of AKI?

<p>Severe dehydration (B)</p> Signup and view all the answers

What effect do nephrotoxins have on the kidneys?

<p>They damage proximal tubular cells responsible for reabsorption. (A)</p> Signup and view all the answers

What is a possible outcome of prolonged urinary obstruction?

<p>Increased pressure in the nephrons. (D)</p> Signup and view all the answers

Which of the following infections can lead to prerenal acute kidney injury (AKI)?

<p>Sepsis. (D)</p> Signup and view all the answers

Which risk factor for AKI is particularly significant for older adults?

<p>Reduced renal reserve. (C)</p> Signup and view all the answers

What condition can occur due to kidney stones?

<p>Hydronephrosis. (D)</p> Signup and view all the answers

Which medication type is a risk factor for intrarenal AKI?

<p>Aminoglycosides. (B)</p> Signup and view all the answers

How does heart failure contribute to prerenal AKI?

<p>It reduces renal perfusion due to decreased cardiac output. (A)</p> Signup and view all the answers

What is one primary reason for developing postrenal AKI?

<p>Urinary tract obstruction. (A)</p> Signup and view all the answers

Flashcards

Acute Kidney Injury (AKI)

A sudden decline in kidney function, resulting in reduced glomerular filtration, fluid and electrolyte imbalances, and accumulation of nitrogenous waste products in the blood.

Prerenal AKI

The most common cause of AKI, characterized by inadequate blood flow to the kidneys.

Intrarenal AKI

Causes of AKI that directly damage the kidney structures, such as acute tubular necrosis, glomerulonephritis, and acute interstitial nephritis.

Acute Tubular Necrosis (ATN)

A type of intrarenal AKI caused by damage to the renal tubules due to ischemia or nephrotoxins.

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Postrenal AKI

Causes of AKI where the flow of urine is obstructed, leading to pressure buildup in the nephrons.

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Renal Hypoperfusion

The state of decreased renal blood flow, which reduces glomerular filtration rate (GFR) and leads to insufficient blood flow to the nephrons.

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Ischemic Necrosis

Prolonged prerenal AKI can progress to this condition, causing cell death and damage in the renal tubules.

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GFR Recovery

The process of kidney function recovering quickly when blood flow is restored.

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Nephrotoxins

Injury to the proximal tubular cells, which are responsible for reabsorption, caused by substances like certain antibiotics and NSAIDs.

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Kidney stones

Solid formations in the kidney that block urine flow, leading to increased pressure and damage.

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Glomerulonephritis

Inflammation of the glomerulus, the filtering unit of the kidney, caused by immune complexes. This leads to protein and blood in the urine.

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Prostatic hypertrophy (BPH)

Enlargement of the prostate gland in men, which can obstruct urine flow from the bladder.

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Hydronephrosis

A condition where the kidneys swell due to backed-up urine, caused by obstruction in the urinary tract.

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Reduced renal perfusion

Decreased blood flow to the kidneys, often due to conditions like heart failure or shock.

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Autoimmune kidney disease

A condition where the body's immune system attacks the kidneys, leading to damage and inflammation.

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Prerenal AKI risk factors

Conditions like dehydration, shock, and heart failure that reduce blood flow to the kidneys.

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Study Notes

Acute Kidney Injury (AKI)

  • AKI is a sudden decrease in kidney function, leading to reduced glomerular filtration, fluid and electrolyte imbalances, and accumulation of nitrogenous waste products in the blood.

Causes of AKI

  • Classified into three categories:
    • Prerenal: Most common, caused by reduced blood flow to the kidneys. This can be due to low blood pressure (hypotension), low blood volume (hypovolemia), or heart problems causing inadequate blood flow.
    • Intrarenal: Damage within the kidney itself. This can include direct damage to kidney structures (e.g., acute tubular necrosis from ischemia or nephrotoxins), inflammatory conditions (glomerulonephritis). Acute interstitial nephritis and allergic reactions to drugs.
    • Postrenal: Blockage of urine flow. This can be due to obstructions like kidney stones, enlarged prostate, or tumors.

Pathophysiology

  • The sequence of events depends on the type of AKI.
    • Prerenal: Reduced blood flow to the kidneys reduces glomerular filtration rate (GFR). Hypoxia (lack of oxygen) in the kidney tissue can injure cells and potentially lead to acute tubular necrosis (ATN) if not treated. GFR can recover if blood flow is restored.
    • Intrarenal: Damage directly to the kidney tissue, often followed by ischemia (lack of blood flow) and necrosis of renal tubular cells. Nephrotoxins can directly damage proximal tubular cells which are crucial for reabsorption.
    • Postrenal: Blockage of urine outflow increases pressure within the nephrons, which reduces filtration. Prolonged blockage can lead to hydronephrosis (swelling of the kidney) and damage to the nephrons. Casts formed by damaged tubular cells can block urine flow, further injuring the kidney.

Transmission

  • Not transmissible. AKI is not an infectious disease.

Risk Factors

  • Prerenal: Dehydration, hemorrhage, shock, heart failure
  • Intrarenal: Nephrotoxins (certain antibiotics, NSAIDs), glomerulonephritis, sepsis
  • Postrenal: Kidney stones, prostatic hypertrophy, tumors

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Description

This quiz covers the essential concepts of Acute Kidney Injury (AKI), including its definition, causes, and pathophysiology. Learn about the distinctions between prerenal, intrarenal, and postrenal causes of AKI and understand their impact on kidney function.

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