Prescribing Safety Assessment (PSA) Practice Exam

Which of the following is a cause of intrinsic acute kidney injury (AKI)?

1. Benign Prostate Hyperplasia

2. Nephrotoxic Antibiotics

3. Prostate Cancer

4. Kidney Stones

The correct answer is: Nephrotoxic Antibiotics

Intrinsic acute kidney injury (AKI) refers to damage to the kidney tissues themselves, primarily affecting the renal tubules, glomeruli, or interstitial tissues. The renal tubules are particularly sensitive to various insults, including nephrotoxins, which can lead to acute tubular necrosis. Nephrotoxic antibiotics are a well-known cause of intrinsic AKI because they can directly damage the renal tubules. Certain antibiotics, such as aminoglycosides (e.g., gentamicin), can lead to renal impairment due to their potential to cause cellular toxicity and necrosis in kidney tubules. This direct injury is a hallmark of intrinsic AKI. Recognizing nephrotoxic medications is crucial for preventing and managing AKI in patients, especially those who may already have risk factors for kidney injury. On the other hand, conditions such as benign prostate hyperplasia, prostate cancer, and kidney stones generally do not cause direct damage to kidney tissues. Instead, they may lead to post-renal obstructive causes of AKI, where urine flow is obstructed, creating pressure on the kidneys, which can lead to renal impairment over time. However, these conditions do not fall under the intrinsic mechanisms leading to kidney damage the way nephroto