Causes of Acute Renal Failure

PRERENAL FAILURE

•Volume deplection resulting from:
Hemorrhage
Renal losses (diuretics, osmotic diuresis)
Gastrointestinal losses (vomiting, diarrhea, nasogastric suction)

• Impaired cardiac efficiency resulting from:
Myocardial infarction
Heart failure
Dysrhythmiasis
Cardiogenic shock

• Vasodilation resulting from:
Sepsis
Anaphylaxis
Antihypersentensive medication or other medications that causes vasodilation



INTRARENAL FAILURE

•Prolonged renal ischemia resulting from:
Pigment nephropaty (associated with the breakdown of blood cells containing pigments that in turn occlude kidney structures)
Myoglobinuria (trauma, crush injuries, burns)
Hemoglobinuria (transfusion, reaction, hemolytic anemia)

•Nephrotoxic agents such as:
Aminoglycoside antibiotics (gentamicin, tobramycin)
Radiopaque contrast agents
Heavy metals (lead, mercury)
Solvents and chemicals (ethylene glycol, carbon tetrachloride, arsenic)
Nonsterodal anti-inflammatory drugs (NSAID’s)
Angiotensin- converting enzyme inhibitors (ACE inhibitor)

•Infectious process such as:
Acute pyelonephritis
Acute glomerulonephritis



POSTRENAL FAILURE

•Urinary tract obstruction, including:
Calculi (stones)
Tumors
Benign prostatic hyperplasia
Strictures
Blood clots

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