Renal failure, acute

Renal failure, acute


Obstruction, reduced circulation, and renal parenchymatous disease can all cause sudden interruption of kidney function. Acute renal failure is usually reversible with medical treatment; otherwise, it may progress to end-stage renal disease, uremic syndrome, and death.


Acute renal failure can be classified as prerenal, intrinsic (or parenchymatous), or postrenal.

Prerenal failure

Diminished blood flow to the kidneys causes prerenal failure. Such decreased flow may result from hypovolemia, shock, embolism, blood loss, sepsis, pooling of fluid in ascites or burns, or a
cardiovascular disorder, such as heart failure, arrhythmias, and tamponade. Other causes include disorders of the blood, such as idiopathic thrombocytopenic purpura, transfusion reactions, and other hemolytic disorders; malignant hypertension; and disorders resulting from childbirth-like bleeding (associated with placental abruption or placenta previa) that can damage the kidneys. Autoimmune disorders, such as scleroderma, can also cause acute renal failure.

Intrinsic renal failure

Parenchymatous, or intrinsic, renal failure results from damage to the kidneys themselves, usually resulting from acute tubular necrosis. Such damage may also result from acute poststreptococcal glomerulonephritis, systemic lupus erythematosus, polyarteritis nodosa, vasculitis, sickle cell disease, bilateral renal vein thrombosis, nephrotoxins, ischemia, renal myeloma, and acute pyelonephritis.

Postrenal failure

Bilateral obstruction of urine outflow results in postrenal failure. Possible causes include renal calculi, clots, papillae from papillary necrosis, tumors, benign prostatic hyperplasia, strictures, and urethral edema from catheterization.

Signs and symptoms

Acute renal failure is a critical illness. Its early signs are oliguria, azotemia and, rarely, anuria. Electrolyte imbalances, metabolic acidosis, and other severe effects follow as the patient becomes increasingly uremic and renal dysfunction disrupts other body systems:

Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Renal failure, acute

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