AKI

Question 1

What is AIN pathologically?

Answer 1

Inflammation of the interstitium (connective tissue between the tubules) usually due to a hypersensitivity reaction

Question 2

Causes of AIN ?

Answer 2

Most commonly due to drugs
- NSAIDS
- Penicillins
- Abacavir
- PPI
- Allopurinol
- Phenytoin 
Autoimmune 
- SLE
- Sarcoid
Other 
- HIV
- leukaemia/lymphoma

Question 3

How does AIN present?

Answer 3

Rash, Fever, AKI, Eosinophiluria and elevated IgE

Usually 10 days after drug exposure ( can be sooner if previous exposure)

Question 4

Management of AIN ?

Answer 4

Stop Drug

Question 5

What is the pathogenesis of ATN ?

Answer 5

Ischaemia or direct toxin causing necrosis and denuding of the epithelium with tubular occlusion

Question 6

Causes of ATN?

Answer 6

Pre-renal hypovolaemia can cause ischaemic ATN

Drugs 
Contrast 
Aminoglycosides
Tenofovir
Platinums
Amphotericin B
heavy metals 

Pigment

Question 7

RF for ATN?

Answer 7

Age
Hypertesnion 
CKD
Diabetes
Vascular disease
Heart failure
Liver disease
NSAIDS
ARB/ACE

Question 8

Classic presentation of atheroembolic disease?

Answer 8

Livedo reticularis, vasculitis rash, ischaemic digits, eosinophillia

Question 9

Pathogeneisis of Hepatorenal syndrome

Answer 9

Altered vasoregulation from changes in splanchnic cirulation causing pre-renal failure

Question 10

MOA for Tumour lysis causing AKI?

Answer 10

Uric acd and calcium precipitate in the tubules

Question 11

When to consider Renal artery stenosis?

Answer 11

Flash APO
U and E worse when starting ace
Asymetrical kidney