ARF - Acute Renal Failure

Question 1

Azotemia

Answer 1

Accumulation of nitrogenous wastes

Question 2

Uremia

Answer 2

Symptomatic renal failure

Question 3

Oliguria

Answer 3

urine output <400-500 ml/24 hours

Question 4

Anuria

Answer 4

urine output < 100 ml/24 hours

Question 5

ARF

Answer 5

0.5 mg/dl increase if in Cr if baseline Cr 2.0

Question 6

ARF - Major etiologies (3)

Answer 6

1. PreRenal
2. Renal / Intrinsic
3. PostRenal

Question 7

Intrinsic ARF

Answer 7

1. ATN - Acute Tubular Necrosis
2. AIN - Acute Interstitial Nephritis
3. Acute GN
4. Acute vascular syndrome
5. Intratubular obstruction

Question 8

Most common community acquired ARF?

Answer 8

Prerenal

Question 9

Most common hospital acquired ARF?

Answer 9

Intrinsic - ATN

Question 10

PreRenal ARF - ethologies(5)?

Answer 10

1. Volume Depletion
2. Decreased effective blood volume
   
   1. CHF
   2. cirrhosis
   3. nephrotic syndrome
   4. sepsis
3. Renal Vasoconstriction
   
   1. HeptoRenal Syndrome
   2. HyperCalcemia
   3. NSAIDS
4. ACE/ARBs
5. Increased Renal Vein Pressure -
   abdominal compartment syndrome

Question 11

Renal / Intrinsic AKI - ethologies(4)?

Answer 11

1. ATN (85%)
   
   1. Ischemia (50%)
   2. Toxins (30%)
2. AIN - Acute Intersisital Nephritis (8%)
3. GN (5%)
4. Vascular (2)

Question 12

AIN - Acute Interstitial Nephritis

Answer 12

1. Acute Renal Failure due to LYMPHOCYTIC infiltration of the interstitium
2. Classic Triad of
   
   1. Fever
   2. Rash
   3. Eosinophilia

Question 13

AIN - Ethiologies

Answer 13

1. Drug induced (penicilins, cephalosporins, NSAIDs)
2. Malignancy
3. Infection related (bacterial, viral, rickettsial, TB)
4. Systemic disease: SLE, sarcoidosis

Question 14

ATN - Ethiologies

Answer 14

1. Ischemic (30%)
   
   1. prolong prerenal azotemia
   2. hypotention
   3. hypovolemic shock
2. Nephrotoxic (20%)
   
   1. drug induced
      
      1. radiocontrast agents
      2. aminoglycosides
      3. amphotericn B
      4. cisplatin
   2. pigment nephropathy
      
      1. hemoglobin
      2. myoglobin
3. Sepsis (50%)