Which factor can cause prerenal AKI due to decreased perfusion?

Which factor can cause prerenal AKI due to decreased perfusion?

• A. Distributive shock (decrease in blood volume)
• B. Obstructive uropathy
• C. Acute tubular necrosis
• D. Interstitial nephritis

Answer: (A)

Prerenal AKI occurs when the kidneys don’t get enough blood flow, so the glomerular filtration rate drops even though the kidney tissue itself is initially intact. Distributive shock lowers effective arterial blood volume and renal perfusion due to widespread vasodilation and blood pooling, so the kidneys receive less blood flow and filtration falls. This is a perfusion problem rather than direct kidney injury. The other scenarios involve issues within the kidney or urinary tract itself: an obstruction blocks urine outflow and raises pressure (postrenal), ischemic or toxin-related damage injures the tubular cells (acute tubular necrosis), and inflammation within the kidney (interstitial nephritis) is an intrinsic renal process.

Prerenal AKI occurs when the kidneys don’t get enough blood flow, so the glomerular filtration rate drops even though the kidney tissue itself is initially intact. Distributive shock lowers effective arterial blood volume and renal perfusion due to widespread vasodilation and blood pooling, so the kidneys receive less blood flow and filtration falls. This is a perfusion problem rather than direct kidney injury.

The other scenarios involve issues within the kidney or urinary tract itself: an obstruction blocks urine outflow and raises pressure (postrenal), ischemic or toxin-related damage injures the tubular cells (acute tubular necrosis), and inflammation within the kidney (interstitial nephritis) is an intrinsic renal process.