Acute Kidney Injury vs Chronic Kidney Disease
Acute Kidney Injury and Chronic Kidney Disease are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Acute Kidney Injury vs Chronic Kidney Disease at a glance
- Acute Kidney Injury: Abrupt decline in renal function categorized as prerenal, intrarenal, or postrenal.
- Chronic Kidney Disease: Persistent decline in GFR or kidney damage for ≥3 months, staged by eGFR and albuminuria.
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Side-by-side comparison
| Feature | Acute Kidney Injury | Chronic Kidney Disease |
|---|---|---|
| At a glance | Abrupt decline in renal function categorized as prerenal, intrarenal, or postrenal. | Persistent decline in GFR or kidney damage for ≥3 months, staged by eGFR and albuminuria. |
| Classic presentation | Asterixis, pericardial friction rub, and uremic frost suggest advanced uremia requiring urgent dialysis evaluation.; Often asymptomatic; detected on routine… | Small echogenic kidneys on ultrasound (except in diabetes, amyloid, HIV-associated nephropathy, and PKD where kidneys may be normal or enlarged).; Often… |
| Workup / key labs | KDIGO AKI: Stage 1 (Cr 1.5-1.9× baseline or +0.3 mg/dL; UOP <0.5 mL/kg/h × 6-12 h). Stage 2 (Cr 2.0-2.9× baseline; UOP <0.5 mL/kg/h × ≥12 h). Stage 3 (Cr ≥3×… | CKD requires kidney damage OR eGFR <60 for ≥3 months. Staged G1-G5 by eGFR (G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15) and A1-A3 by UACR (A1… |
| Imaging | Renal ultrasound — rules out obstruction (hydronephrosis) and assesses kidney size/echogenicity; Bladder scan — postvoid residual >150-200 mL suggests outlet… | Renal ultrasound — assess size, echogenicity, cysts, obstruction |
| First-line treatment | Identify and treat underlying cause (volume, sepsis, obstruction, nephrotoxin withdrawal); Prerenal: isotonic crystalloid (lactated Ringer's or normal saline)… | BP target <120/80 (KDIGO 2021); use validated office BP measurement; ACEi (lisinopril, ramipril, enalapril) or ARB (losartan, valsartan, irbesartan) —… |
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