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Intrinsic renal AKI
Post renal AKI
Pre renal AKI
100

What are the 4 categories of Intrinsic renal AKI's?

Give 1 example of each? 

1. Vascular 

- Haematological causes e.g) TTP, DIC 

- Vascular causes e.g) Artheroembolism 

2. Glomerular 

- Glomerularnephritis 

3. Tubular 

- Acute tubular necrosis (nephrotoxic or ischaemic cause) 

4. Interstitial 

- interstitial nephritis (commonly drug induced) 

100

Name 4 causes of post renal obstruction. Briefly describe how this leads to an AKI? 

-Stones

-Blood clots

-Malignancy (intra obstruction or compression)

-BPH (men)

- Scar tissue 


2. Increased Backpressure: The obstruction results in a build-up of urine in the kidneys. Leads to reduced GFR, thus leading to glomerular and tubular ischaemia. This leads to necrosis and if chronic (scarring) 

100

What are three signs or symptoms that may indicate prerenal AKI?

low BP, tachycardia, low JVP, tissue turgor, dry mucous membranes

100

Explain Rhabdomyolysis? 

Name 2 risk factors? 

What category of intrinsic renal AKI does it fall under?

What substance is toxic to the kidney? 

1. A breakdown of muscle tissue that releases a damaging protein into the blood.

2. Crushing injury, 3rd degree burns, statins, extreme exercise 

3. Acute tubular necrosis, Nephrotoxic cause 

4. Myoglobin is nephrotoxic 

100

A common cause of a post renal AKI is a Kidney stone (Caliculi). What are the 3 points a kidney stone is most likely to deposit?

  • Pelviureteric Junction (PUJ), where the renal pelvis becomes the ureter.
  • Crossing the pelvic brim, where the iliac vessels travel across the ureter in the pelvis (SIJ landmark)
  • Vesicoureteric Junction (VUJ), where the ureter enters the bladder.
100

 In a patient with prerenal AKI, what findings would you expect on the following investigations: serum:urea ratio (elevated/lowered), urinalysis (normal/abnormal), urine osmolality (high/low)?

Elevated serum:urea ratio, normal urinalysis, high urine osmolality

150

In the context of prerenal AKI, explain the difference between volume depletion and effective volume depletion, and give an example of each.

A: Volume depletion is total loss of body fluids causing hypoperfusion of the kidneys, whereas in effective volume depletion there is still a significant amount of fluid in the body but it is in body cavities instead of in the circulation so it does not reach the kidneys

150

What is thought to be the precipitating cause of prerenal AKI in patients with hepatorenal syndrome?

Decreased systemic blood pressure secondary to splanchnic vasodilation resulting in decreased perfusion to kidneys