Causes and Prognosis of Acute Tubular Injury
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Questions and Answers

What is the most common cause of Acute Tubular Injury (ATI)?

  • Direct toxic injury: drugs, radio-contrast dyes, myoglobin, hemoglobin, and radiation
  • Overwhelming sepsis or other causes of Multi-organ failure
  • Ischemia: shock, dehydration, malignant hypertension (correct)
  • Inflammation of the tubules and interstitium (tubulointerstitial nephritis)

    • Which part of the nephron is most affected in ischemic ATI?

  • Distal convoluted tubule
  • Proximal tubule straight segments (PST) and thick ascending loop of Henle (HL) (correct)
  • Glomerulus
  • Collecting duct

    • Which of the following is a characteristic of the recovery phase of ATI?

  • Salt and water overload
  • Oliguria (40-400 mL/day)
  • Hyperkalemia
  • Rising urine volumes (up to 3 L/day) with water, sodium, and especially potassium losses (hypokalemia) (correct)

    • Which of the following is a poor prognostic factor for ATI?

    <p>ATI secondary to overwhelming sepsis or other causes of Multi-organ failure</p> Signup and view all the answers

    Which of the following is a characteristic of nephrotoxic ATI?

    <p>Variable degrees of tubular injury and necrosis, mostly in proximal tubules</p> Signup and view all the answers

    How does hypertension affect the renal vasculature?

    <p>Hypertension affects renal vessels, and any renal vascular changes tend to amplify the hypertension</p> Signup and view all the answers

    What is the main cause of malignant nephrosclerosis?

    <p>Endothelial injury, platelet deposition, and increased vascular permeability</p> Signup and view all the answers

    What is the main feature of benign nephrosclerosis?

    <p>Rarely causes renal failure</p> Signup and view all the answers

    What is the main structural change seen in nephrosclerosis?

    <p>Medial and intimal thickening of small renal arteries and arterioles</p> Signup and view all the answers

    What is the most common cause of malignant hypertension?

    <p>Accelerated hypertension</p> Signup and view all the answers

    What is the main feature of thrombotic microangiopathies?

    <p>Fibrinoid necrosis and intravascular thrombosis</p> Signup and view all the answers

    What is the main cause of nephrosclerosis?

    <p>Medial and intimal thickening of small renal arteries and arterioles, strongly associated with hypertension</p> Signup and view all the answers

    What is the most common cause of acute renal failure in hospitalized patients?

    <p>Drug-induced interstitial nephritis</p> Signup and view all the answers

    Which disorder is characterized by renal calcium deposition and can lead to renal failure through tubular obstruction?

    <p>Nephrocalcinosis</p> Signup and view all the answers

    What percentage of multiple myeloma patients have Bence Jones proteinuria?

    <p>70%</p> Signup and view all the answers

    Which of the following conditions has eosinophils and edema present in the interstitium?

    <p>Ischemic ATI</p> Signup and view all the answers

    In Light Chain Cast Nephropathy, what toxic effect contributes to renal insufficiency?

    <p>Bence Jones proteinuria</p> Signup and view all the answers

    Which condition is characterized by a T cell–mediated immune reaction to a drug causing interstitial inflammation in the kidney?

    <p>Drug-induced interstitial nephritis</p> Signup and view all the answers

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