Acute renal failure classification: Difference between revisions
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{{Acute renal failure}} | {{Acute renal failure}} | ||
==Classification Based on | ==Classification Based on Causes== | ||
=== | Acute renal failure is usually categorised (as in the flowchart below) according to ''pre-renal, renal'' and ''post-renal'' causes. | ||
{{familytree/start}} | |||
{{familytree | | | | | | | | | A01 | | | | | |A01=Acute Renal<br>Failure}} | |||
{{familytree | | | | |,|-|-|-|-|+|-|-|-|-|.| |}} | |||
{{familytree | | | | B01 | | | B02 | | | B03|B01=Pre-renal|B02=Renal|B03=Post-renal }} | |||
{{familytree/end}} | |||
*[[ | * ''Pre-renal'' (causes in the blood supply): | ||
*[[ | ** [[hypovolemia]] (decreased blood volume), usually from [[Shock (medical)|shock]] or [[dehydration]] and fluid loss or excessive [[diuretic]]s use. | ||
** [[hepatorenal syndrome]] in which renal [[perfusion]] is compromised in [[liver failure]] | |||
*[[ | ** vascular problems, such as [[atheroembolic disease]] and [[renal vein thrombosis]] (which can occur as a complication of the [[nephrotic syndrome]]) | ||
*[[ | * ''Renal'' (damage to the kidney itself): | ||
*[[ | ** [[infection]] usually [[sepsis]] (systemic inflammation due to infection),rarely of the kidney itself, termed [[pyelonephritis]] | ||
*[[ | ** [[toxin]]s or [[medication]] (e.g. some [[NSAID]]s, [[aminoglycoside]] [[antibiotics]], [[iodinated contrast]], [[Lithium salt|lithium]]) | ||
** [[rhabdomyolysis]] (breakdown of [[muscle]] tissue) - the resultant release of [[myoglobin]] in the [[blood]] affects the kidney; it can be caused by [[injury]] (especially crush injury and extensive [[blunt trauma]]), [[statin]]s, [[stimulant]]s and some other drugs | |||
** [[hemolysis]] (breakdown of [[red blood cell]]s) - the [[hemoglobin]] damages the [[tubules]]; it may be caused by various conditions such as [[sickle-cell disease]], and [[lupus erythematosus]] | |||
** [[multiple myeloma]], either due to [[hypercalcemia]] or "cast nephropathy" (multiple myeloma can also cause [[chronic renal failure]] by a different mechanism) | |||
*[[ | ** acute [[glomerulonephritis]] which may be due to a variety of causes, such as [[anti glomerular basement membrane disease]]/[[Goodpasture's syndrome]], [[Wegener's granulomatosis]] or acute [[lupus nephritis]] with [[systemic lupus erythematosus]] | ||
* ''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. | ||
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Revision as of 14:27, 24 August 2012
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Classification Based on Causes
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 (causes in the blood supply):
- hypovolemia (decreased blood volume), usually from shock or dehydration and fluid loss or excessive diuretics use.
- hepatorenal syndrome in which renal perfusion is compromised in liver failure
- vascular problems, such as atheroembolic disease and renal vein thrombosis (which can occur as a complication of the nephrotic syndrome)
- Renal (damage to the kidney itself):
- infection usually sepsis (systemic inflammation due to infection),rarely of the kidney itself, termed pyelonephritis
- toxins or medication (e.g. some NSAIDs, aminoglycoside antibiotics, iodinated contrast, lithium)
- rhabdomyolysis (breakdown of muscle tissue) - the resultant release of myoglobin in the blood affects the kidney; it can be caused by injury (especially crush injury and extensive blunt trauma), statins, stimulants and some other drugs
- hemolysis (breakdown of red blood cells) - the hemoglobin damages the tubules; it may be caused by various conditions such as sickle-cell disease, and lupus erythematosus
- multiple myeloma, either due to hypercalcemia or "cast nephropathy" (multiple myeloma can also cause chronic renal failure by a different mechanism)
- acute glomerulonephritis which may be due to a variety of causes, such as anti glomerular basement membrane disease/Goodpasture's syndrome, Wegener's granulomatosis or acute lupus nephritis with systemic lupus erythematosus
- 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.