Acute Kidney Injury 2

Question 1

What is the gold standard for GFR estimation?

Answer 1

Inulin clearance.

Question 2

Why is inulin clearance not used routinely?

Answer 2

It is expensive and impractical for regular clinical use.

Question 3

What is the traditional formula for estimating GFR in children?

Answer 3

Schwartz formula.

Question 4

What are the age-dependent k values in the Schwartz formula?

Answer 4

Premature infant: 0.33, Term infant (up to 1 year): 0.45, Child/adolescent girl: 0.55, Adolescent boy: 0.7.

Question 5

What is the adapted formula for enzymatic creatinine measurement?

Answer 5

CKiD Schwartz formula.

Question 6

For what GFR range is the CKiD Schwartz formula accurate?

Answer 6

15–75 mL/min/1.73 m².

Question 7

What is the reference GFR value for a premature infant?

Answer 7

<10 mL/min/1.73 m².

Question 8

What is the GFR reference for term infants?

Answer 8

10–40 mL/min/1.73 m².

Question 9

What is the GFR value for a 2-year-old child?

Answer 9

110–120 mL/min/1.73 m².

Question 10

What factors affect the accuracy of serum creatinine as a GFR marker?

Answer 10

Non-steady kidney function, diet, hydration, medications, and hyperbilirubinemia.

Question 11

What percentage of creatinine is secreted by the renal tubules?

Answer 11

10–40%.

Question 12

What are the advantages of cystatin C over serum creatinine?

Answer 12

Independent of muscle mass, age, gender, and race; effective in early AKI detection.

Question 13

What is a clinical use of cystatin C in AKI?

Answer 13

It predicts AKI 2 days before serum creatinine rise.

Question 14

What are the limitations of cystatin C?

Answer 14

Lack of standardization in measurement.

Question 15

Why is serum creatinine a limited marker for AKI?

Answer 15

Its rise is delayed and significant renal damage has occurred by the time of diagnosis.

Question 16

What is the earliest biomarker for AKI?

Answer 16

Neutrophil Gelatinase-Associated Lipocalin (NGAL).

Question 17

When does NGAL become detectable?

Answer 17

1–3 days before AKI diagnosis.

Question 18

What does KIM-1 detect?

Answer 18

Acute tubular necrosis (ATN).

Question 19

How long does KIM-1 remain elevated after AKI?

Answer 19

6–12 hours initially, stays high for 48 hours.

Question 20

What injury does Interleukin-18 (IL-18) indicate?

Answer 20

Proximal tubular injury.

Question 21

When does L-FABP appear in AKI?

Answer 21

Within 4 hours post-cardiopulmonary bypass (CPB) in children.

Question 22

What does N-Acetyl-β-Glucosaminidase (NAG) indicate?

Answer 22

Tubular cell injury, such as nephrotoxicity or ischemia.

Question 23

What is the benefit of combining biomarkers for AKI detection?

Answer 23

Increased sensitivity and specificity in early detection.

Question 24

Which biomarkers are detectable early in AKI?

Answer 24

NGAL and L-FABP (2–4 hours).

Question 25

What is the importance of sequential biomarker panels?

Answer 25

They enhance diagnostic accuracy, especially in critical care settings.