NBME 27 Acute tubular necrosis from ischemia (NBME Answers)

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submitted by ∗shak360(19)

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There are three types of AKI

Prerenal azotemia - urine osmolality is increased (above 500 mOsm/kg), a BUN to creatinine ratio of greater than 20, a fractional excretion of sodium less than 1%
Intrinsic renal failure - urine osmolality is decreased (below 350 mOsm/kg), a BUN to creatinine ratio of less than 20, fractional excretion of sodium greater than 2%, and (muddy brown epithelial/granular casts in ATN)
Postrenal azotemia - urine osmolality is decreased (below 350 mOsm/kg), and other lab values often vary

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