Nephrology: Acute Kidney Injury and Chronic Kidney Disease

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Questions and Answers

What is the primary cause of Post-Renal AKI?

Nephrotoxic drugs

BPH (correct)

Cardiogenic shock

Hypovolemia

What is the primary goal of treatment for volume overload in CKD patients?

Increase aldosterone secretion

Reduce potassium levels

Increase blood pressure

Reduce sodium intake (correct)

What is the treatment for hyperkalemia in CKD patients?

Loop diuretic therapy

ACEI/ARB therapy

Potassium supplementation

Potassium restriction (correct)

What is the stage of CKD characterized by an eGFR of 15-29 mL/min/1.73m²?

G4: 15-29 Signup and view all the answers

What is the primary treatment for metabolic acidosis in CKD patients?

Bicarbonate supplementation Signup and view all the answers

What is the primary goal of ESA therapy in CKD patients?

Increase hemoglobin levels Signup and view all the answers

Which of the following is a cause of Pre-Renal Acute Kidney Injury (AKI)?

Hypovolemia Signup and view all the answers

What is the characteristic urine feature in Pre-Renal Acute Kidney Injury (AKI)?

High urine osmolality and specific gravity Signup and view all the answers

What is used to calculate CrCl if the actual body weight is greater than the ideal body weight by more than 25%?

Adjusted Body weight Signup and view all the answers

What is the primary complication of phosphorus retention in End-Stage Renal Disease (ESRD)?

Hypocalcemia Signup and view all the answers

What is the diagnostic criterion for Acute Renal Failure (Acute Kidney Injury)?

Scr ↑ by 0.3 mg/dL within 48 hours Signup and view all the answers

What is the primary goal of non-emergency potassium removal from the body?

To remove excess potassium Signup and view all the answers

What is the characteristic laboratory feature of Renal Acute Kidney Injury (AKI)?

BUN/Cr ratio ≤ 15 Signup and view all the answers

What is the urinary albumin excretion rate for Albuminuria Stage A2?

30-300 mg/day Signup and view all the answers

What is the Child-Pugh classification used for?

Classification of Cirrhosis Signup and view all the answers

What is the definition of Chronic Kidney Disease (CKD)?

eGFR < 60 mL/min/1.73 m2 or urinary albumin excretion of ≥ 30 mg/day for > 3 months Signup and view all the answers

What is the characteristic urine feature in Renal Acute Kidney Injury (AKI)?

Low urine osmolality and specific gravity Signup and view all the answers

Study Notes

Acute Kidney Injury (AKI) Causes and Features

Post-Renal AKI is primarily caused by urinary tract obstruction, which impedes urine flow.
Pre-Renal AKI is commonly due to conditions that reduce renal perfusion, such as dehydration or heart failure.
Characteristic urine feature of Pre-Renal AKI includes oliguria with high urine osmolality and sodium concentration.
Renal AKI is characterized by muddy brown casts in urine and often shows a lower urine osmolality.

Chronic Kidney Disease (CKD) Management

Volume overload in CKD patients is primarily treated with diuretics to help remove excess fluid.
Hyperkalemia in CKD patients is managed using medications like insulin, beta-agonists, or calcium gluconate to stabilize cardiac membranes.
Metabolic acidosis in CKD patients is primarily treated with sodium bicarbonate to restore normal pH levels.
Erythropoiesis-Stimulating Agent (ESA) therapy in CKD aims to increase hemoglobin levels and improve anemia symptoms.

Staging and Classification

CKD stage characterized by eGFR of 15-29 mL/min/1.73m² is classified as Stage 4.
Chronic Kidney Disease (CKD) is defined by a persistent decrease in kidney function, indicated by an eGFR of less than 60 mL/min/1.73m² for at least three months.
The Child-Pugh classification is used to assess the severity of liver disease, not kidney disease.

Laboratory and Diagnostic Features

Urinary albumin excretion rate for Albuminuria Stage A2 is defined as 30-299 mg/g.
Diagnostic criterion for Acute Renal Failure (AKI) includes a rise in serum creatinine by 0.3 mg/dL or more within 48 hours.
Primary complication of phosphorus retention in End-Stage Renal Disease (ESRD) is secondary hyperparathyroidism, leading to bone disease.

Potassium Management

Primary goal of non-emergency potassium removal from the body is to prevent life-threatening complications like cardiac arrest due to hyperkalemia.
Creatinine clearance (CrCl) calculation should use the adjusted body weight formula when actual body weight exceeds ideal body weight by more than 25%.

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Description

Test your knowledge of Post-Renal AKI, its causes and resolution, as well as CKD stages and complications. Learn about the effects of BPH on the urinary tract and the importance of eGFR in diagnosing renal failure.