Kidney toxicity

Question 1

Define acute kidney injury

Answer 1

Characterized by an abrupt decline in GFR with resulting azotemia.

Question 2

Inflammatory cells are attracted to what type of area?

Answer 2

Areas of low oxygen tension, ischemic injury

Question 3

Pre-renal injury

Answer 3

Diuretics, ACEi, ARBs

Question 4

Vasoconstriction

Answer 4

NSAIDS, radiocontrast, cyclosporine, tacrolimus, ampho B

Question 5

crystalluria

Answer 5

sulfa, methotrexate, acyclovir, triamterene,protease inhibitors

Question 6

Interstitial nephritis

Answer 6

antibiotics, NSAIDS, diuretics

Question 7

Glomerulopathy

Answer 7

penicillamine, NSAIDS

Question 8

What is crystalluria

Answer 8

precipitation in tubules causing obstruction

Question 9

Acetaminophen (tylenol) can cause what?

Answer 9

Proximal tubule necrosis. High BUN Serum creatinine, Lower GFR

Question 10

NSAIDS

Answer 10

1) inhibit prosta synthesis, vasoconstriction leads to decreased renal blood flow and ischmia
2) Chronic NSAIDS an d acetaminophen produces analgesic nephropathy (interstitial nephritis and papillary necrosis

3) Interstitial nephritis is a more rare form of injury

Question 11

Aminoglycosides

Answer 11

Big lysosomes which contain toxic phospholipid

Rupture of said lysosome exposes cytoplasm to the contents

Question 12

Ampho-B

Answer 12

Impairs proxmal and renal tubules. Impairs blod flow and GFR

Question 13

Cyclosporine

Answer 13

acute reversible renal dysfunction and

Question 14

Cisplatin

Answer 14

Inhibits DNA synthesis and transport. focal necrosis in the nephron. Glomerulus is unaffected. Loss of 10-30% of renal function

Question 15

Radiocontrast

Answer 15

Very nephrotoxic. Acute vasoconstriction and cellular generation of ROS.