Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary system > Acute kidney injury > Flashcards

Acute kidney injury Flashcards

1
Q

What are the types of kidney failure?

A

Acute kidney injury (AKI)

Chronic kidney disease (CKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant by acute kidney injury?

A

Abrupt decrease in actual GFR, reduced kidney function over a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the clinical definition of acute kidney injury?

A

Increase in serum creatinine, decrease in eGFR

Decrease in urine volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the disadvantage of using serum creatinine to define acute kidney injury?

A

Takes a few days for serum creatinine levels to increase after decrease in actual GFR and kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the groups of causes of acute kidney injury?

A

Pre-renal

Intra-renal

Post-renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is meant by a pre-renal cause of acute kidney injury?

A

Acute kidney injury due to decreased blood supply to kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some examples of pre-renal causes of acute kidney injury?

A

Hypovolaemia - haemorrhage, vomiting and diarrhoea, severe burns

Hypotension - anaphylactic shock, septic shock, congestive heart failure

Renal artery stenosis, embolism

Impaired renal autoregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause impaired renal autoregulation?

A

Drugs

  • NSAIDS
  • ACE inhibitors
  • Angiotensin2 receptor antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do ACE inhibitors cause impaired renal autoregulation?

A

Inhibit angiotensin 2
which vasoconstricts efferent arteriole
loss of this gives vasodilation of efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do angiotensin 2 receptor antagonists cause impaired renal autoregulation?

A

Inhibit angiotensin 2
which vasoconstricts the efferent arteriole
loss of this gives vasodilation of efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does the kidney respond to pre-renal acute kidney injury?

A

RAAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is pre-renal acute kidney injury treated?

A

Fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How well does pre-renal acute kidney injury respond to fluid treatment?

A

If blood supply to kidney was high enough to keep cells alive
then responds well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can pre-renal acute kidney injury develop into?

A

Intra-renal acute kidney injury

acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is meant by an intra-renal cause of acute kidney injury?

A

Acute kidney injury due to abnormality of kidney itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some examples of intra-renal causes of acute kidney injury?

A

Acute glomerulonephritis

Acute tubular necrosis

Acute interstitial nephritis

Acute pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cause of acute kidney injury?

A

Intra-renal acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is acute tubular necrosis?

A

Cell damage but not cell necrosis

damaged cells cannot reabsorb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the causes of acute tubular necrosis?

A

Ischaemic hypoxia - severe pre-renal acute kidney injury

Nephrotoxins

Sepsis

20
Q

What parts of the nephron are most affected by ischaemic hypoxia? Why?

A

Proximal convoluted tubule S3

Loop of Henle thick ascending limb

Lots of reabsorption occurs here so have high metabolic demand
but are deeper in medulla where pO2 is lower

21
Q

What is the difference between pre-renal acute kidney injury and acute tubular necrosis caused by ischaemic hypoxia? What is the exception to this?

A

Pre-renal acute kidney injury, still have some cell function, some reabsorption

Acute tubular necrosis due to ischaemic hypoxia, cells too damaged to function, reduced reabsorption

Exception is patient on diuretic, itself gives reduced reabsorption

22
Q

How is pre-renal acute kidney injury differentiated from acute tubular necrosis caused by ischaemic hypoxia clinically?

A

Pre-renal acute kidney injury - high urine osmolality, low urine sodium

Acute tubular necrosis caused by ischaemic hypoxia - low urine osmolality, high urine sodium

23
Q

What is meant by a nephrotoxin?

A

Substance that damages epithelial cells lining the nephron tubules

24
Q

What are some examples of endogenous nephrotoxins?

A

Myoglobin

Bilirubin

Urate

25
Q

What are some examples of exogenous nephrotoxins?

A

Endotoxins

Drugs

26
Q

What causes high levels of myoglobin in the blood?

A

Rhabdomyolysis

27
Q

What is meant by rhabdomyolysis?

A

Rapid breakdown of skeletal muscle cells

28
Q

What are some examples of causes of rhabdomyolysis?

A

Crush injurt

Lack of blood flow to a limb

29
Q

What is a renal sign of rhabdomyolysis?

A

Dark urine

30
Q

What is meant by thrombotic microangiopathy?

A

Thrombosis in capillaries due to damage to the endothelium

31
Q

How does thrombotic microangiopathy affect red blood cells?

A

Passing red blood cells are torn apart

32
Q

How does thrombotic microangiopathy cause intra-renal kidney failure?

A

Damage to glomerular capillary membrane

33
Q

What is meant by acute interstitial nephritis?

A

Inflammation of the tissue surrounding the nephron tubules

34
Q

What are the causes of acute interstitial nephritis?

A

Infections

Drugs e.g. antiobiotics, NSAIDS, proton-pump inhibitors

which both cause inflammation

35
Q

What is meant a post-renal cause of acute kidney injury?

A

Acute kidney injury caused by obstruction of urinary tract after kidneys, both kidneys

36
Q

How does obstruction of the urinary tract cause acute kidney injury?

A

Increase in tubular pressure
increased hydrostatic pressure in Bowman’s capsule
reduced GFR

37
Q

What are some examples of post-renal causes of acute kidney injury?

A

Lumen - stones, tumours,

Wall - stricture

External - enlarged prostate, tumour, aortic aneurysms

38
Q

Why does a post-renal cause of acute injury have to involve both kidneys?

A

Because otherwise the other kidney will compensate by increased urine excretion
no change in serum levels of fluid, electrolytes

39
Q

What age group is post-renal acute kidney injury most common in?

A

Elderly

40
Q

How does acute kidney injury affect serum levels?

A

Increased urea

Increased creatinine

41
Q

What are the complications of acute kidney injury?

A

Hyperkalaemia

Metabolic acidosis

Hyponatraemia

Hypocalcaemia

42
Q

How can acute kidney injury cause metabolic acidosis?

A

Reduced reabsorption and production of bicarbonate ions in proximal convoluted tubule and later distal convoluted tubule and collecting duct

Reduced secretion of hydrogen ions in later distal convoluted tubule and collecting duct

43
Q

How can acute kidney injury cause hyperkalaemia?

A

Tissue damage releases it from cells

Metabolic acidosis causes potassium to move out of cells

Reduced GFR

Reduced distal delivery of sodium ions, reduced secretion in collecting duct

Drugs e.g. RAAS inhibitors, potassium-sparing diuretics,

44
Q

What are the signs of hyperkalaemia?

A

Cardiac arrythmias

45
Q

What does the ECG of a patient with hyperkalaemia look like?

A

Tall T waves

Small or absent P waves

Increased P-R interval

Wide QRS complex

Urinary system (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions