ChemPath: Assessment of Renal Function 2

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Total cards: 24•Content version: v4•Public deck•Updated: 8/1/2026

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Front (Question)

Define AKI.

Back (Answer)

Rapid reduction in kidney function, leading to inability to maintain electrolyte, acid-base and fluid homeostasis.

Front (Question)

What are the three stages of AKI?

Back (Answer)

Stage 1: increase in serum creatinine by 1.5-1.9 times baseline Stage 2: increase in serum creatinine by 2-2.9 times baseline Stage 3: increase in serum creatinine by >3 times baseline

Front (Question)

What is pre-renal AKI?

Back (Answer)

AKI caused by reduced renal perfusion

Front (Question)

Describe the normal response to reduced circulating volume.

Back (Answer)

• Activation of central baroreceptors and renin-angiotensin system • Release of vasopressin • Activation of sympathetic system • Results in vasoconstriction, increased cardiac output and renal sodium retention

Front (Question)

Name and describe the two mechanisms that maintain renal blood flow despite changes in systemic blood pressure.

Back (Answer)

• Myogenic stretch - if the afferent arteriole gets stretched due to high pressure, it will constrict to reduce the transmission of that pressure to the glomerulus • Tubuloglomerular Feedback - high chloride concentration in the early distal tubule (suggestive of high GFR) stimulates constriction of the afferent arteriole which lowers GFR and, hence, chloride concentration

Front (Question)

List some causes of pre-renal AKI.

Back (Answer)

• True volume depletion • Hypotension • Oedematous state • Selective renal ischaemia (e.g. renal artery stenosis) • Drugs affecting renal blood flow

Front (Question)

List some drugs that affect renal blood flow.

Back (Answer)

• ACE inhibitors - reduce efferent arteriolar constriction • NSAIDs - decreased afferent arteriolar constriction • Calcineurin inhibitors - decrease afferent arteriolar constriction • Diuretics - affect tubular funciton and decrease preload

Front (Question)

What is a consequence of prolonged pre-renal insult?

Back (Answer)

Acute tubular necrosis (ATN)

Front (Question)

What might be seen on urine microscopy in a patient with ATN?

Back (Answer)

Epithelial cell casts

#10

Front (Question)

What causes post-renal AKI?

Back (Answer)

Physical obstruction of urine flow

#11

Front (Question)

List some sites of urine obstruction.

Back (Answer)

• Intra-renal • Ureteric • Prostatic/urethral • Blocked urinary catheter

#12

Front (Question)

Outline the pathophysiology of post-renal AKI.

Back (Answer)

• GFR is dependent on a hydraulic pressure gradient • Obstruction results in increased tubular pressure • This results in an immediated decline in GFR

#13

Front (Question)

What are some consequences of prolonged renal obstruction?

Back (Answer)

• Glomerular ischaemia • Tubular damage • Long-term interstitial scarring

#14

Front (Question)

List the possible sites of disease in intrinsic AKI.

Back (Answer)

• Vascular (e.g. vasculitis) • Glomerular (e.g. glomerulonephritis) • Tubular (e.g. ATN) • Interstitial (e.g. AIN)

#15

Front (Question)

What can cause direct tubular injury?

Back (Answer)

• Ischaemia (MOST COMMON) • Endoengous toxins (e.g. myoglobin, immunoglobulin) • Exogenous toxins (e.g. aminoglycosides, amphotericin, aciclovir)

#16

Front (Question)

Which diseases can cause AKI due to infiltration/abnormal protein deposition?

Back (Answer)

• Amyloidosis (associated with nephrotic syndrome) • Lymphoma • Myeloma

#17

Front (Question)

List the possible outcomes of AKI.

Back (Answer)

• Partial recovery of renal function • Discharged with increased serum creatinine • Discharged requiring chronic dialysis • Death

#18

Front (Question)

What are the biochemical definitions of AKI?

Back (Answer)

• Increase in serum creatinine > 26.5µmol/L within 48 hours • Increase in serum creatinine > 1.5 times baseline within the previous 7 days • Urine volume < 0.5 ml/kg/hr for 6 hours

#19

Front (Question)

What are the four processes of acute wound healing?

Back (Answer)

• Haemostasis • Inflammation • Proliferation • Remodelling

#20

Front (Question)

What are the stages of CKD?

Back (Answer)

• Stage 1: >90 • Stage 2: 60-89 • Stage 3: 30-59 • Stage 4: 15-29 • Stage 5: <15

#21

Front (Question)

List some causes of CKD.

Back (Answer)

• Diabetes mellitus • Hypertension • Chronic glomerulnephritis • Atherosclerotic renal disease • Infective or obstructive uropathy • Polycystic kidney disease

#22

Front (Question)

What are the normal roles of the kidney?

Back (Answer)

• Excretion of water-soluble waste • Water balance • Electrolyte balance • Acid-base homeostasis • Endocrine (EPO, RAS, vitamin D)

#23

Front (Question)

Outline the consequences of CKD.

Back (Answer)

• Progressive failure of homeostatic function (acidosis, hyperkalaemia) • Progressive failure of hormonal function (anaemia, renal bone disease) • Cardiovascular disease (vascular calcifiction, uraemic cardiomyopathy) • Uraemia and death

#24

Front (Question)

What are the consequences of renal acidosis?

Back (Answer)

• Muscle and protein degradation • Osteopaenia due to mobilisation of bone calcium • Cardiac dysfunction