Prescribing Safety Assessment (PSA) Practice Exam

Which of the following is NOT a pre-renal cause of AKI?

1. Dehydration

2. Sepsis/shock

3. Renal artery stenosis

4. Chronic kidney disease

The correct answer is: Chronic kidney disease

Chronic kidney disease (CKD) is characterized by a gradual loss of kidney function over time, rather than an acute decline in function. It represents a state where the kidneys are already compromised, consistent with intrinsic renal pathology rather than a cause of acute kidney injury (AKI). In contrast, pre-renal causes of AKI are typically related to factors that reduce renal perfusion and thereby impair kidney function. Dehydration leads to decreased blood volume and perfusion to the kidneys, sepsis or shock can cause systemic hypotension, and renal artery stenosis results in reduced blood flow to the kidneys, both of which are classified as pre-renal causes. Recognizing CKD as a separate condition highlights its distinction from the acute conditions that lead to pre-renal AKI. Understanding the differentiation between pre-renal, intrinsic, and post-renal causes of AKI is crucial in the clinical assessment and management of patients with kidney function declines.