Which is NOT a prerenal AKI cause?

• A. Nephrotoxic drugs
• B. Severe burns
• C. Hemorrhage
• D. Distributive shock

Answer: (A)

Prerenal AKI happens when the kidneys aren’t getting enough blood flow, so the issue is systemic perfusion rather than damage to kidney tissue itself. Severe burns cause big fluid losses and reduced effective circulating volume, leading to underperfusion of the kidneys. Hemorrhage lowers circulating blood volume, again decreasing renal blood flow. Distributive shock, with widespread vasodilation, reduces the effective arterial blood flow reaching the kidneys. Nephrotoxic drugs, however, damage the kidney tissue directly (intrinsic AKI) rather than just cutting off blood flow, so they are not prerenal causes. Understanding this helps you differentiate between types of AKI and guides appropriate treatment, since prerenal AKI often improves with restoring perfusion, while intrinsic AKI requires different, targeted kidney-protective strategies.