What is a common cause of acute kidney injury in hospitalized patients?

• A. Hypervolemia.
• B. Excessive hydration.
• C. Hypovolemia/dehydration, nephrotoxic medications, and sepsis.
• D. Chronic liver disease.

Answer: (C)

The common causes of acute kidney injury in hospitalized patients are related to decreased kidney perfusion, direct injury from drugs, and systemic infection. When volume is lost or not properly circulating (hypovolemia/dehydration), the kidneys receive less blood flow, lowering the glomerular filtration rate and leading to AKI. Nephrotoxic medications and certain contrast agents can directly injure kidney tubules or disrupt renal blood flow, causing intrinsic kidney injury. Sepsis compounds the problem by causing widespread inflammation and hemodynamic instability, which impairs renal perfusion and can trigger kidney injury.

Hypervolemia and excessive hydration are less typical primary triggers for AKI in the hospital, though they can contribute to complications in other ways. Chronic liver disease can lead to kidney problems like hepatorenal syndrome, but the combination of hypovolemia, nephrotoxic medications, and sepsis covers the most common hospital-related causes.