L14- acute kidney injury

Question 1

What are the main causes of acute kidney injury?

Answer 1

Pre renal e.g. perfusion failure
Renal e.g. Intrinsic disease of the kidney
Post Renal e.g. Obstruction of the urinary system

Question 2

What can cause perfusion failure and lead to pre renal acute kidney injury?

Answer 2

hypotension
hypovolaemia
renal artery occlusion

Question 3

What treatments can make perfusion failure to the kidney worse?

Answer 3

RAAS blockage
NSAIDS
Antihypertensives
Diuretics

Question 4

What is the result of a pre renal perfusion failure?

Answer 4

This causes sympathetic activity to increase to the renal vessels. This causes increased renin release to try and increase the blood volume however it also causes vasoconstriction. This leads to increased Na+ and water retention and a decreased GFR, this also reduces oxygen supply to the kidneys.

Question 5

What is the first part of the kidney to be affected in hypoxia?

Answer 5

The renal medulla as the vasa recta is not very good at dealing with CO2 and O2.

Question 6

What is a protection method for the kidney from hypoxia?

Answer 6

Urodilatin is released from the kidneys during hypoxia in order to cause vasodilation and inhibit Na/K ATPase

Question 7

What are the causes of post renal obstruction?

Answer 7

stones
benign prostate
tumours
fibrosis

Question 8

What are the renal causes of acute kidney injury?

Answer 8

Systemic diseases e.g. Vasculitis, SLE
Infection e.g. HIV, endocarditis
Drug toxicity
glomerulonephritis

Question 9

What is vasculitis?

Answer 9

Autoimmune attack that damages blood vessels mainly of airways and kidneys.

Question 10

What are the treatments for inflammatory renal disease?

Answer 10

Steroids
cyclophosphamide - infections
Plasma exchange
azathioprine - infection