American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a significant complication in patients with systemic vasculitis involving the renal arteries?

1. Acute kidney injury

2. Chronic obstructive pulmonary disease

3. Cirrhosis

4. Diabetes mellitus

The correct answer is: Acute kidney injury

Acute kidney injury is a significant complication in patients with systemic vasculitis involving the renal arteries due to the inflammatory damage these conditions cause to renal blood vessels. Vasculitis can lead to narrowing, occlusion, or thrombosis of these vessels, which can severely impair blood flow to the kidneys. This reduction in renal perfusion can result in ischemia, causing the kidneys to deteriorate and leading to acute renal failure, characterized by a sudden decline in kidney function and increased serum creatinine levels. In addition, systemic vasculitis often activates an intense inflammatory response, which can further contribute to renal injury. The kidneys are particularly susceptible to damage from systemic processes, especially when blood vessels are involved, highlighting the importance of recognizing and managing vasculitis promptly to prevent acute kidney injury. While the other conditions listed may have serious health implications, they do not typically arise as direct or immediate complications of systemic vasculitis involving the renal arteries.