Lecture 7

Question 1

What characterizes acute kidney injury?

Answer 1

Reduction in renal function (GFR)

-leads to resulting in azotemia (too much urea and N2 in blood)

Question 2

True or False: Oliguria (urine volume <400 ml/day) may be observed in acute kidney injury

Answer 2

True

Question 3

True or False: Acute kidney injury could arise secondary to a dental surgical procedure and/or procedure-related drug treatment

Answer 3

True

Question 4

Prolonged systemic hypotension, sepsis, hypovolemia, or renal artery obstruction can lead to what type of acute renal injury?

Answer 4

Pre-renal injury

Question 5

Acute tubular necrosis is an example of what kind of acute kidney injury?

Answer 5

Intra-renal injury

Question 6

Causes of acute tubular necrosis?

Answer 6

-Aminoglycoside antibiotics
(gentamicin, tobramycin),
-Tetracycline
-Radiocontrast
-Ischemia

Question 7

_____: immune system activation causes inflammation, sclerosis and obstruction.

Answer 7

Sepsis
(intra-renal injury)

Question 8

Anything that causes urinary tract obstruction will result in what type of renal injury?

Answer 8

Post-renal injury

Question 9

True or False: Inadequate perfusion or hypoxia leads to cellular dysfunction, death (necrosis) and sloughing of renal tubular epithelial cells

Answer 9

True

Question 10

Where parts of the kidney does acute tubular necrosis affect first and WHY?

Answer 10

PCT and thick ascending limb of the loop of Henle
-These segments are the main
sites for ACTIVE transport and rely on O2 utilization a lot!!!

Question 11

True or False: Occlusion of the tubular lumen may occur due to dead cells clumping or sloughing off

Answer 11

True

Question 12

What is the effects of occlusion of the tubular lumen on GFR and fluid?

Answer 12

-Reduced GFR
-Leakage of fluid back into the interstitium

Question 13

How can one recovery from acute kidney injury and acute tubular necrosis?

Answer 13

Regeneration of tubule cells

Question 14

If the initial insult (e.g. ischemia) has been corrected, the return of GFR to normal
can take _____ depending on the severity of the insult

Answer 14

3-21 days (or longer)

Question 15

If acute renal injury does not occur or is incomplete, ______ results

Answer 15

chronic kidney disease (CKD)

Question 16

True or False: Chronic Kidney Disease is defined as the presence of kidney damage (histological evidence or microalbuminuria) or decreased kidney function (GFR < 60 ml/min/1.73 m2) for 3 or more months

Answer 16

True

Question 17

True or False: CKD can be a primary manifestation of a chronic disease which goes unrecognized
and/or is inadequately treated.

Answer 17

False - CKD can be a SECONDARY manifestation of a chronic disease which goes unrecognized and/or is inadequately treated

Question 18

Diabetes mellitus contributes to
__% of the cases for severe
Chronic Kidney Disease while Hypertension
contributes to __% of CKD cases

Answer 18

45%; 27%

Question 19

True or False: The presence of
CKD in either DM or HTN greatly increases the risk of dying from ischemic cardiovascular disease

Answer 19

True

Question 20

Is mild to moderate (stage 1-3) CKD is symptomatic or asymptomatic

Answer 20

asymptomatic

Question 21

How can you detect CKD early?

Answer 21

-Treat HTN/DM
-Check proteinuria or serum creatinine

Question 22

Why should patients who do not have hypertension, but have microalbuminuria, should be placed on
anti-RAAS therapy?

Answer 22

Reduce proteinuria