Acute Kidney Injury

What is AKI?

• An increase in creatinine that reverses within 1 week

• An abrupt decline in glomerular filtration

• A decline in renal function with reduced urine output

• Any change in serum creatinine that is accompanied by hyperkalaemia

Which of the following is an indication for acute dialysis?

• A doubling of serum creatinine

• Hyponatraemia present for more than 48 hours

• Poor response to IV diuresis

• Resistant hyperkalaemia

Which of the following statements about serum creatinine is true?

• Serum creatinine is influenced by diet and muscle bulk

• Serum creatinine is a sensitive and specific marker of proximal tubular injury

• Changes in serum creatinine are evident within 6 hours of renal injury

• Tubular secretion of creatinine is increased by beta lactam antibiotics

Which of the following statements is false?

• Patients who recover fully from an episode of AKI are not at an increased risk of developing CKD

• AKI is associated with increased hospital costs and mortality

• The KDIGO classification system is a harmonisation of the RIFLE and AKIN systems

• CKD is a risk factor for the development of AKI

Which of the following is a biomarker of kidney damage?

• Serum Creatinine

• Plasma Cystatin C

• Urinary NGAL

• Serum Creatine Kinase

Which of the following statements regarding contrast-associated AKI is correct?

• Patient risk factors include age < 60 years

• Glucocorticoids are used in the treatment of established contrast-associated AKI

• The risk of this complication is higher with coronary angiogram than contrast-enhanced CT

• N-acetylcysteine is integral for its prevention

Regarding Vancomycin nephrotoxicity, which of the following statements is FALSE?

• Obesity is a risk factor for vancomycin nephrotoxicity

• Newer preparations of vancomycin are very rarely associated with nephrotoxicity

• The addition of tazocin to vancomycin therapy has been shown to increase the risk of nephrotoxicity

• Vancomycin is predominantly eliminated unchanged via the kidneys

A 59-year old woman is noted to have an increase in her serum creatinine from 57umol/L to 198umol/L within 48 hours of hospital admission. She has a history of Type 2 Diabetes Mellitus and cervical cancer. Which of the following imaging modalities is the most appropriate to initial investigation?

• MRI Kidneys

• Renogram

• CT Urogram

• Renal Ultrasound Scan