Acute renal failure classification: Difference between revisions
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* '''Renal''' (damage to the kidney itself): | * '''Renal''' (damage to the kidney itself): | ||
** | ** Diseases affecting the renal vasculature - | ||
** [[ | *** Renal arterial obstruction: [[atherosclerosis]], [[dissecting aneurysm]], [[thrombosis]], [[embolism]] | ||
* | *** Renal venous obstruction: [[thrombosis]] of the [[veins]] | ||
** [[ | ** Diseases affecting | ||
** | |||
* ''Post-renal'' (obstructive causes in the urinary tract) due to: | * ''Post-renal'' (obstructive causes in the urinary tract) due to: | ||
** [[medication]] interfering with normal bladder emptying. | ** [[medication]] interfering with normal bladder emptying. |
Revision as of 18:54, 24 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Acute renal failure can complicate a wide spectrum of disorders, and for the purpose of diagnosis and management is divided according to the mechanism that lead to renal compromise. The three categories are pre-renal azotemia (diseases that cause renal hypoperfusion), renal azotemia (diseases directly affecting the renal parenchyma), and post-renal azotemia (diseases affecting the urinary tract causing obstruction).
Classification
Acute renal failure is usually categorised (as in the flowchart below) according to pre-renal, renal and post-renal causes.
Acute Renal Failure | |||||||||||||||||||||||||||||||||
Pre-renal | Renal | Post-renal | |||||||||||||||||||||||||||||||
- Pre-renal (compromise in the renal blood flow):
- Hypovolemia (decreased blood volume) -
- Shock, hemorrhage, burns, dehydration
- Fluid loss from diuretics use, diabetes mellitus, hypoadrenalism
- Gastrointestinal fluid loss: vomiting, surgical drainage, diarrhea
- Extra-vascular space sequestration: pancreatitis, hypoalbuminemia, peritonitis, trauma, burns
- Low cardiac output -
- Cardiac arrhthymia's
- Congestive heart failure: left ventricular failure, right ventricular failure
- Valvular disorders: severe aortic stenosis
- Severe pulmonary hypertension, massive pulmonary emobolism
- Systemic vasodilatation -
- Hepatorenal syndrome in which renal perfusion is compromised in liver failure (cirrhosis with ascites)
- Vascular problems -
- Atheroembolic disease
- Renal vein thrombosis (which can occur as a complication of the nephrotic syndrome)
- Renal hypoperfusion from cyclooxygenase inhibitors, ACE inhibitors
- Renal vasoconstriction from hypercalcemia, cyclosporine, tacrolimus and amphotericin B
- Hyperviscosity syndrome -
- Hypovolemia (decreased blood volume) -
- Renal (damage to the kidney itself):
- Diseases affecting the renal vasculature -
- Renal arterial obstruction: atherosclerosis, dissecting aneurysm, thrombosis, embolism
- Renal venous obstruction: thrombosis of the veins
- Diseases affecting
- Diseases affecting the renal vasculature -
- Post-renal (obstructive causes in the urinary tract) due to:
- medication interfering with normal bladder emptying.
- benign prostatic hypertrophy or prostate cancer.
- kidney stones.
- due to abdominal malignancy (e.g. ovarian cancer, colorectal cancer).
- obstructed urinary catheter.