Differential Diagnosis for Acute Kidney Injury (AKI)
Single Most Likely Diagnosis
- Prerenal AKI: This is the most common cause of AKI, often due to volume depletion (e.g., dehydration, bleeding), heart failure, or liver disease. It is characterized by a decrease in renal perfusion, leading to a reduction in glomerular filtration rate (GFR).
Other Likely Diagnoses
- Intrinsic Renal AKI: This category includes causes such as acute tubular necrosis (ATN) from ischemia or toxins (e.g., certain medications, contrast agents), and glomerulonephritis. These conditions directly damage the renal parenchyma.
- Postrenal AKI: Obstruction of the urinary tract, which can be caused by kidney stones, tumors, or other conditions that block the flow of urine, leading to a buildup of waste products in the blood.
- Sepsis-associated AKI: Sepsis can cause AKI through a combination of hypoperfusion, inflammation, and direct renal injury.
Do Not Miss Diagnoses
- Rhabdomyolysis: A condition where muscle breakdown leads to the release of myoglobin, which can cause severe kidney damage if not promptly treated.
- Uric acid nephropathy: Elevated uric acid levels can crystallize in the renal tubules, causing obstruction and AKI, often seen in tumor lysis syndrome.
- Atheroembolic disease: Cholesterol crystals embolizing to the kidneys can cause AKI, especially in patients with atherosclerosis undergoing vascular procedures.
Rare Diagnoses
- Vasculitis: Inflammation of the blood vessels, including those supplying the kidneys, can lead to AKI.
- Thrombotic microangiopathy: A disorder characterized by the formation of blood clots in small blood vessels, including those in the kidneys, which can cause AKI.
- Cystinosis: A rare genetic disorder that can cause kidney damage and AKI due to the accumulation of cystine crystals within the kidneys.