What is a common cause of acute kidney injury in hospitalized patients?

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Multiple Choice

What is a common cause of acute kidney injury in hospitalized patients?

In hospitalized patients, reduced kidney perfusion from volume depletion or shock is a leading cause of acute kidney injury. When blood flow to the kidneys falls, glomerular filtration drops, and the kidneys respond by reabsorbing water and sodium to preserve circulating volume. This results in a higher BUN relative to creatinine, a low urinary sodium, and a concentrated urine—classic signs of prerenal azotemia. The urine findings typically show a BUN/creatinine ratio greater than about 20 and a fractional excretion of sodium (FENa) less than 1%. In the hospital, common triggers include diuretic overuse, vomiting or diarrhea causing volume loss, sepsis or other states of hypoperfusion, and acute blood loss. While obstruction (postrenal) or intrinsic renal diseases (like glomerulonephritis or acute tubular necrosis from toxins) can cause AKI, prerenal azotemia from decreased perfusion remains the most frequent, especially early in the hospitalization. Chronic kidney disease, by contrast, is a preexisting condition and represents a baseline state rather than an acute cause.

In hospitalized patients, reduced kidney perfusion from volume depletion or shock is a leading cause of acute kidney injury. When blood flow to the kidneys falls, glomerular filtration drops, and the kidneys respond by reabsorbing water and sodium to preserve circulating volume. This results in a higher BUN relative to creatinine, a low urinary sodium, and a concentrated urine—classic signs of prerenal azotemia. The urine findings typically show a BUN/creatinine ratio greater than about 20 and a fractional excretion of sodium (FENa) less than 1%.

In the hospital, common triggers include diuretic overuse, vomiting or diarrhea causing volume loss, sepsis or other states of hypoperfusion, and acute blood loss. While obstruction (postrenal) or intrinsic renal diseases (like glomerulonephritis or acute tubular necrosis from toxins) can cause AKI, prerenal azotemia from decreased perfusion remains the most frequent, especially early in the hospitalization. Chronic kidney disease, by contrast, is a preexisting condition and represents a baseline state rather than an acute cause.

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