AKI, CKD, and ESRD Causes

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Questions and Answers

Which of the following is a common cause of prerenal acute kidney injury (AKI)?

  • Low blood pressure (correct)
  • Kidney stones
  • Nephrotoxins
  • Glomerulonephritis

Which of the following conditions is the most common cause of chronic kidney disease (CKD)?

  • Glomerulonephritis
  • Diabetes mellitus (correct)
  • Polycystic kidney disease
  • Chronic pyelonephritis

End-stage renal disease (ESRD) is characterized by a glomerular filtration rate (GFR) that is what percentage of normal?

  • Less than 50%
  • Less than 1%
  • Less than 10% (correct)
  • Less than 25%

Damage to the glomeruli or tubules, leading to impaired reabsorption/secretion and a buildup of nitrogenous wastes, is characteristic of which type of acute kidney injury (AKI)?

<p>Intrarenal AKI (C)</p> Signup and view all the answers

Which of the following directly contributes to glomerular hypertension and fibrosis in chronic kidney disease (CKD)?

<p>Angiotensin II (A)</p> Signup and view all the answers

What is the primary mechanism by which proteinuria worsens tubulointerstitial damage in chronic kidney disease (CKD)?

<p>Promoting tubulointerstitial inflammation and fibrosis (A)</p> Signup and view all the answers

Which clinical manifestation is commonly associated with acute kidney injury (AKI)?

<p>Oliguria or anuria (C)</p> Signup and view all the answers

What electrolyte imbalance is typically observed in chronic kidney disease (CKD)?

<p>Hyperkalemia and hyperphosphatemia (A)</p> Signup and view all the answers

Which clinical feature is commonly associated with end-stage renal disease (ESRD)?

<p>Severe anemia (D)</p> Signup and view all the answers

In postrenal AKI, increased pressure in Bowman's capsule directly leads to what physiological consequence?

<p>Decreased glomerular filtration rate (C)</p> Signup and view all the answers

What is the primary adaptive mechanism in the remaining nephrons during chronic kidney disease (CKD), as described by the 'intact nephron hypothesis'?

<p>Compensation through hyperfiltration (B)</p> Signup and view all the answers

A patient with chronic kidney disease (CKD) is likely to experience which specific bone disorder as a result of the disease?

<p>CKD-MBD (Mineral and Bone Disorder) (C)</p> Signup and view all the answers

Which of the following is the most direct consequence of reduced GFR, urine concentration, and waste elimination in ESRD?

<p>Uremic syndrome (A)</p> Signup and view all the answers

Which of the following best describes the role of chronic inflammation and oxidative stress in the progression of chronic kidney disease (CKD)?

<p>They drive disease progression (B)</p> Signup and view all the answers

Given that recurrent episodes of AKI can accelerate the progression to ESRD, what underlying pathophysiological change is MOST likely driving this progression?

<p>Cumulative and irreversible nephron damage (B)</p> Signup and view all the answers

A researcher is studying the effects of a novel drug designed to modulate the renin-angiotensin-aldosterone system (RAAS) in patients with CKD. Which specific outcome would BEST indicate the drug's effectiveness in slowing CKD progression?

<p>Reduced glomerular hypertension (A)</p> Signup and view all the answers

A patient with long-standing diabetes mellitus develops proteinuria, hypertension, and declining renal function. If a kidney biopsy reveals glomerulosclerosis and tubulointerstitial fibrosis, which of the following pathogenic mechanisms is MOST likely contributing to these findings?

<p>Chronic hyperglycemia leading to advanced glycation end-product (AGE) formation (D)</p> Signup and view all the answers

Progressive nephron loss in chronic kidney disease (CKD) leads to compensatory mechanisms in the remaining nephrons. Which of the following is a potential long-term consequence of this compensation?

<p>Increased nephron size and hyperfiltration (B)</p> Signup and view all the answers

A patient presents with symptoms of uremia, including nausea, vomiting, and altered mental status. What is the underlying cause of these symptoms?

<p>Accumulation of toxins in the body (D)</p> Signup and view all the answers

A patient's acute kidney injury (AKI) is determined to be due to obstruction. Which classification of AKI is this?

<p>Postrenal (A)</p> Signup and view all the answers

Flashcards

Prerenal AKI

Reduced blood flow to the kidneys, often due to low blood pressure, leading to decreased kidney function.

Intrarenal AKI

Direct damage to kidney tissue, such as the glomeruli or tubules, often caused by toxins, infections, or autoimmune diseases.

Postrenal AKI

Obstruction of urinary outflow, leading to backflow of urine into the kidneys and subsequent damage.

Chronic Kidney Disease (CKD)

A condition characterized by gradual and progressive loss of kidney function over time.

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Glomerulonephritis

A condition in which the glomeruli (filtering units) of the kidneys are damaged, leading to proteinuria and impaired kidney function.

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End-Stage Renal Disease (ESRD)

The final stage of CKD, characterized by severe loss of kidney function requiring dialysis or kidney transplantation.

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Intact Nephron Hypothesis

The process where surviving nephrons increase their filtration rate to compensate for damaged nephrons in CKD.

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Proteinuria

Elevated protein levels in the urine, indicating damage to the glomeruli and contributing to kidney inflammation and fibrosis.

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Glomerular Hypertension

Increased blood pressure within the glomeruli, promoting fibrosis and further kidney damage in CKD.

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Uremic Syndrome

A condition characterized by the buildup of toxins in the blood due to impaired kidney function, leading to various systemic symptoms.

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Symptoms of Uremia

A cluster of symptoms including nausea, vomiting, pruritus (itching), and altered mental status, associated with the buildup of toxins in the blood due to kidney failure.

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Dialysis

The use of a machine to filter waste products and excess fluid from the blood when the kidneys are unable to do so.

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Transplantation

A surgical procedure to replace a diseased kidney with a healthy kidney from a donor.

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Oliguria

An abnormally low amount of urine production.

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Anuria

The absence of urine production.

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Elevated Serum Creatinine and BUN

Elevated levels of creatinine and blood urea nitrogen in the blood.

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Electrolyte Imbalances

Imbalances in electrolytes such as potassium (K+) and calcium (Ca2+).

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Electrolyte Imbalances (in CKD)

A condition in which certain blood electrolytes are not within their normal range.

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Anemia (in CKD)

Decreased production of erythropoietin (EPO), leading to reduced red blood cell production.

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CKD-MBD

A mineral and bone disorder associated with chronic kidney disease.

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Study Notes

  • Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), and End-Stage Renal Disease (ESRD) all have different causes.

Acute Kidney Injury (AKI)

  • Prerenal AKI is caused by renal hypoperfusion, such as low blood pressure or volume depletion.
  • Intrarenal AKI comes from direct damage to kidney tissue, such as acute tubular necrosis, glomerulonephritis, or nephrotoxins.
  • Postrenal AKI results from obstruction of urinary outflow, such as from kidney stones, tumors, or an enlarged prostate.

Chronic Kidney Disease (CKD)

  • Diabetes mellitus represents the most common cause.
  • Other causes include hypertension, glomerulonephritis (autoimmune, post-infectious), polycystic kidney disease, chronic pyelonephritis, and prolonged obstruction (e.g., BPH, nephrolithiasis).

End-Stage Renal Disease (ESRD)

  • Represents the final stage of progressive CKD.
  • Glomerular Filtration Rate (GFR) is less than 10% of normal.

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