IVIg Sucrose Osmotic Nephrosis — ESENeph MCQ

Correct answer: D — Prerenal acute kidney injury from severe extracellular-volume depletion

The best answer is “Prerenal acute kidney injury from severe extracellular-volume depletion”. Severe vomiting and weight loss can cause marked salt and water depletion, reduced renal perfusion and oliguria; pregnancy-appropriate fluid, electrolyte and obstetric assessment is urgent. “Acute fatty liver of pregnancy with hepatic and kidney dysfunction” is less appropriate because this typically presents later and the volume-depleted hyperemesis phenotype is more direct “Pre-eclampsia with hypertension, proteinuria and thrombotic microangiopathy” is less appropriate because the gestation and absence of hypertension or proteinuric syndrome argue against it “Bilateral ureteric obstruction from pregnancy-related collecting-system compression” is less appropriate because imaging does not show obstruction “Lupus nephritis with urinary and systemic inflammatory features” is less appropriate because the stem instead provides a strong haemodynamic cause

Reference: UK Kidney Association pregnancy and renal disease guideline: https://www.ukkidney.org/health-professionals/guidelines/pregnancy-and-renal-disease