Acute renal failure causes: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Acute renal failure}} | {{Acute renal failure}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{AN}} | ||
==Overview== | ==Overview== | ||
[[Glomerular filtration rate]] depends on multiple factors, particularly the [[renal blood flow]]. The pressure difference across the renal vasculature i.e the difference in pressure between the renal arterioles and venules is directly proportional to the [[GFR]]. Any decrease in [[renal blood flow]], injury to the renal tubules or obstruction to the urinary tract outflow can cause decreased urinary output. | |||
==Causes== | ==Causes== | ||
===Common Causes=== | |||
Acute renal failure is usually categorised (as in the flowchart below) according to ''pre-renal, renal'' and ''post-renal'' causes. | Acute renal failure is usually categorised (as in the flowchart below) according to ''pre-renal, renal'' and ''post-renal'' causes. | ||
{{familytree/start}} | {{familytree/start}} | ||
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{{familytree/end}} | {{familytree/end}} | ||
===Pre-renal | ====Pre-renal==== | ||
* [[Hypovolemia]] (decreased blood volume) - | * [[Hypovolemia]] (decreased blood volume) - | ||
** [[Shock (medical)|Shock]], [[hemorrhage]], [[burns]], [[dehydration]] | ** [[Shock (medical)|Shock]], [[hemorrhage]], [[burns]], [[dehydration]] | ||
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** Extra-vascular space sequestration: [[pancreatitis]], [[hypoalbuminemia]], [[peritonitis]], [[trauma]], [[burns]] | ** Extra-vascular space sequestration: [[pancreatitis]], [[hypoalbuminemia]], [[peritonitis]], [[trauma]], [[burns]] | ||
*Low cardiac output - | *Low cardiac output - | ||
** [[Cardiac | ** [[Cardiac arrhythmia]]'s | ||
** [[Congestive heart failure]]: [[left ventricular failure]], [[right ventricular failure]] | ** [[Congestive heart failure]]: [[left ventricular failure]], [[right ventricular failure]] | ||
** Valvular disorders: severe [[aortic stenosis]] | ** Valvular disorders: severe [[aortic stenosis]] | ||
** Severe [[pulmonary hypertension]], massive [[pulmonary | ** Severe [[pulmonary hypertension]], massive [[pulmonary embolism]] | ||
* Systemic vasodilatation - | * Systemic vasodilatation - | ||
** [[Anaphylaxis]] | ** [[Anaphylaxis]] | ||
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** [[Atheroembolic disease]] | ** [[Atheroembolic disease]] | ||
** [[Renal vein thrombosis]] (which can occur as a complication of the [[nephrotic syndrome]]) | ** [[Renal vein thrombosis]] (which can occur as a complication of the [[nephrotic syndrome]]) | ||
** Renal [[hypoperfusion]] from [[cyclooxygenase inhibitors]], [[ACE inhibitors]] | ** Renal [[hypoperfusion]] from [[Non-steroidal anti-inflammatory drugs|cyclooxygenase inhibitors]], [[ACE inhibitors]] | ||
** Renal [[vasoconstriction]] from [[hypercalcemia]], [[cyclosporine]], [[tacrolimus]] and [[amphotericin B]] | ** Renal [[vasoconstriction]] from [[hypercalcemia]], [[cyclosporine]], [[tacrolimus]] and [[amphotericin B]] | ||
* [[Hyperviscosity syndrome]] - | * [[Hyperviscosity syndrome]] - | ||
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** [[Polycythemia]] | ** [[Polycythemia]] | ||
** [[Waldenstrom's macroglobulinemia]] | ** [[Waldenstrom's macroglobulinemia]] | ||
===Renal | |||
====Renal==== | |||
* Diseases affecting the renal vasculature - | * Diseases affecting the renal vasculature - | ||
** Renal arterial obstruction: [[atherosclerosis]], [[dissecting aneurysm]], [[thrombosis]], [[embolism]] | ** Renal arterial obstruction: [[atherosclerosis]], [[dissecting aneurysm]], [[thrombosis]], [[embolism]] | ||
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* [[Graft rejection]] | * [[Graft rejection]] | ||
===Post-renal | ====Post-renal==== | ||
* Ureteric: | * Ureteric: | ||
** Ureteric [[calculi]] | ** Ureteric [[calculi]] | ||
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** [[Urethral stricture]]s | ** [[Urethral stricture]]s | ||
** [[Phimosis]] | ** [[Phimosis]] | ||
** | ** Posterior urethral valve | ||
== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {|style="width:80%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Chemical / poisoning''' | | '''Chemical / poisoning''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Amyl Alcohol]], [[Aristolochic acid]], [[Arsenic]], [[Bismuth]], [[Cadmium]], [[Carbon Tetrachloride]], [[Carmustine]], [[Cephaloridine]], [[Chloroform]], [[Chromium]], [[Copper]], [[Diethylene glycol]], [[Dioxane]], [[Gallium]], [[Gasoline]], [[Germanium]], [[Glue sniffing]], [[Gold]], [[Herbicide]], [[Lead]], [[Lithium]], [[Lomustine]], [[Mercury]], [[Methanol]], [[Nitrosourea compounds]], [[Paint thinner]], [[Para-amino salicylic acid]], [[Paraquat ochratoxin A]], [[Perchloroethylene]], [[Pesticide]], [[Platinum]], [[Radiocontrast agents]], [[Silica]], [[Silver]], [[Solvents]], [[Styrene]], [[Sulphonamides]], [[Thallium]], [[Toluene]], [[Trichloroethane]], [[Trichloroethylene]], [[Uranium]], [[Zinc]] overdose | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Dermatomyositis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| [[Acetaminophen]], [[Aminoglycosides]], [[Amphotericin B]], [[Anticancer agents]], [[Aspirin]], [[Bacitracin]], [[Capreomycin]], [[Chlortetracycline]], [[Cidofovir]], [[Cisplatin]], [[Cyclophosphamide]], [[Cyclosporin]], [[Ibuprofen]], [[Ifosfamide]], [[Methicillin]], [[Methotrexate]], [[Mithramycin]], [[Neomycin]], [[Nonsteroidal anti-inflammatory drugs]], [[Oxytetracycline]], [[Polymyxin B]], [[Rifampin]], [[Trimethoprim]], [[Vancomycin]] | |bgcolor="Beige"| [[Acetaminophen]], [[Aminoglycosides]], [[Amlodipine besylate and Valsartan]], [[Amphotericin B]], [[Anticancer agents]], [[Aspirin]], [[Bacitracin]], [[Capreomycin]], [[Chlortetracycline]], [[Cidofovir]], [[Cisplatin]], [[Cyclophosphamide]], [[Cyclosporin]], [[Ibuprofen]], [[Ifosfamide]], [[Methicillin]], [[Methotrexate]], [[Mithramycin]], [[Neomycin]], [[Nonsteroidal anti-inflammatory drugs]], [[Oxytetracycline]], [[Polymyxin B]], [[Rifampin]], [[Trimethoprim]], [[Vancomycin]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Environmental''' | | '''Environmental''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| Agents causing [[methemoglobinemia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| [[Capillary leak syndrome]] with [[monoclonal gammopathy]], [[ | |bgcolor="Beige"| [[Capillary leak syndrome]] with [[monoclonal gammopathy]], [[Disseminated intravascular coagulation]], [[Hemolytic uremic syndrome]], [[Thrombotic thrombocytopenic purpura]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| [[Boutonneuse fever]], [[Clostridium tetani]], [[Diphtheria]], [[Ehrlichiosis]], [[Escherichia coli O157:H7]], [[Hantavirus]], [[Hemorragic fever with renal syndrome]], [[India tick typhus]], [[Israeli spotted fever | |bgcolor="Beige"| [[Boutonneuse fever]], [[Clostridium tetani]], [[Diphtheria]], [[Ehrlichiosis]], [[Escherichia coli O157:H7]], [[Hantavirus]], [[Hemorragic fever with renal syndrome]], [[India tick typhus]], [[Israeli spotted fever]], [[Kenya tick typhus]], [[Leptospirosis]], [[Marseilles fever]], [[Mediterranean Spotted Fever]], [[Toxic shock syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal / Ortho''' | | '''Musculoskeletal / Ortho''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Dermatomyositis]], [[Rhabdomyolysis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Renal / Electrolyte''' | | '''Renal / Electrolyte''' | ||
|bgcolor="Beige"| [[Hepatorenal syndrome]] | |bgcolor="Beige"| [[Mesangial proliferative glomerulonephritis]], [[Post-streptococcal glomerulonephritis]], [[Renal artery stenosis]], [[Membranoproliferative glomerulonephritis]], [[Hemolytic uremic syndrome]], [[Hepatorenal syndrome]], [[Thrombotic thrombocytopenic purpura]], [[Rhabdomyolysis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Rheum / Immune / Allergy''' | | '''Rheum / Immune / Allergy''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Sexual''' | | '''Sexual''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"| [[Blood transfusion]] and its complications, [[Cholesterol embolism]], [[Crush syndrome]], [[Dehydration]], [[Epidemic dropsy]], [[Formaldehyde]], [[Heat stroke]], [[Hyperosmolar non-ketotic diabetic coma]], [[Perioperative mortality|Post-surgical complication]], [[Shock]], [[Tumor lysis syndrome]] | ||
|- | |- | ||
|} | |} | ||
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===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{MultiCol}} | {{MultiCol}} | ||
* [[Bacitracin]] | * [[Bacitracin]] | ||
* [[Bismuth]] | * [[Bismuth]] | ||
* [[Blood transfusion and complications | * [[Blood transfusion]] and complications | ||
* [[Boutonneuse fever]] | * [[Boutonneuse fever]] | ||
* [[Cadmium]] | * [[Cadmium]] | ||
* [[Capillary leak syndrome with monoclonal gammopathy]] | * [[Capillary leak syndrome]] with [[monoclonal gammopathy]] | ||
* [[Capreomycin | * [[Capreomycin]] | ||
* [[Carbon tetrachloride]] | * [[Carbon tetrachloride]] | ||
* [[Carmustine]] | * [[Carmustine]] | ||
* [[Cephaloridine]] | * [[Cephaloridine]] | ||
* [[Chloroform]] | * [[Chloroform]] | ||
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* [[Cisplatin]] | * [[Cisplatin]] | ||
* [[Clostridium tetani]] | * [[Clostridium tetani]] | ||
* [[Copper]] | * [[Copper]] | ||
* [[Crush syndrome]] | * [[Crush syndrome]] | ||
* [[Cyclophosphamide]] | * [[Cyclophosphamide]] | ||
* [[Cyclosporin]] | * [[Cyclosporin]] | ||
* [[Dehydration]] | * [[Dehydration]] | ||
* [[Dermatomyositis]] | * [[Dermatomyositis]] | ||
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* [[Erythroderma]] | * [[Erythroderma]] | ||
* [[Escherichia coli O157:H7]] | * [[Escherichia coli O157:H7]] | ||
* [[Gallium]] | |||
* [[Gallium | |||
* [[Gasoline]] | * [[Gasoline]] | ||
* [[Germanium]] | * [[Germanium]] | ||
* [[Glue | * [[Glue sniffing]] | ||
* [[Gold]] | * [[Gold]] | ||
* [[ | * [[Glycogen storage disease type V]] | ||
* [[Hantavirus]] | * [[Hantavirus]] | ||
* [[Heat stroke]] | * [[Heat stroke]] | ||
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* [[Hepatorenal syndrome]] | * [[Hepatorenal syndrome]] | ||
* [[Herbicide]] | * [[Herbicide]] | ||
* [[Hyperosmolar non-ketotic diabetic coma]] | * [[Hyperosmolar non-ketotic diabetic coma]] | ||
* [[Hyperuricemia]] | * [[Hyperuricemia]] | ||
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* [[Ifosfamide]] | * [[Ifosfamide]] | ||
* [[India tick typhus]] | * [[India tick typhus]] | ||
* [[Israeli spotted fever]] | * [[Israeli spotted fever]] | ||
* [[Kenya tick typhus]] | * [[Kenya tick typhus]] | ||
{{ColBreak}} | {{ColBreak}} | ||
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* [[Membranoproliferative glomerulonephritis]] | * [[Membranoproliferative glomerulonephritis]] | ||
* [[Mercury]] | * [[Mercury]] | ||
* [[ | * [[Mesangial proliferative glomerulonephritis]] | ||
* [[Methanol]] | * [[Methanol]] | ||
* [[ | * [[Methemoglobinemia]] producing agents | ||
* [[Methicillin]] | * [[Methicillin]] | ||
* [[Methotrexate]] | * [[Methotrexate]] | ||
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* [[Nonsteroidal anti-inflammatory drugs]] | * [[Nonsteroidal anti-inflammatory drugs]] | ||
* [[Oxytetracycline]] | * [[Oxytetracycline]] | ||
* [[Paint | * [[Paint thinner]] | ||
* [[Para-amino salicylic acid]] | * [[Para-amino salicylic acid]] | ||
* [[Paraquat ochratoxin A]] | * [[Paraquat ochratoxin A]] | ||
* [[Perchloroethylene]] | * [[Perchloroethylene]] | ||
* [[Pesticide | * [[Pesticide]] | ||
* [[Platinum]] | * [[Platinum]] | ||
* [[Polymyxin]] | * [[Polymyxin]] | ||
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* [[Post-streptococcal glomerulonephritis]] | * [[Post-streptococcal glomerulonephritis]] | ||
* [[Pre-eclampsia]] | * [[Pre-eclampsia]] | ||
* [[Radiocontrast agents]] | * [[Radiocontrast agents]] | ||
* [[Renal artery stenosis]] | * [[Renal artery stenosis]] | ||
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* [[Silver]] | * [[Silver]] | ||
* [[Styrene]] | * [[Styrene]] | ||
* [[ | * [[Solvents]] | ||
* [[Sulphonamides]] | * [[Sulphonamides]] | ||
* [[ | * [[Perioperative mortality|Post-surgical complication]] | ||
* [[Thallium]] | * [[Thallium]] | ||
* [[Thrombotic thrombocytopenic purpura]] | * [[Thrombotic thrombocytopenic purpura]] | ||
* [[Toluene]] | * [[Toluene]] | ||
* [[Toxic shock syndrome]] | * [[Toxic shock syndrome]] | ||
* [[Trichloroethane]] | * [[Trichloroethane]] | ||
* [[Trichloroethylene]] | * [[Trichloroethylene]] | ||
* [[Trimethoprim]] | * [[Trimethoprim]] | ||
* [[Tumor lysis syndrome]] | * [[Tumor lysis syndrome]] | ||
* [[Uranium]] | * [[Uranium]] | ||
* [[Vancomycin]] | * [[Vancomycin]] | ||
* [[Zinc | * [[Zinc]] overdose | ||
{{EndMultiCol}} | {{EndMultiCol}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Nephrology]] | |||
[[Category:Medical emergencies]] | [[Category:Medical emergencies]] | ||
[[Category:Kidney diseases]] | [[Category:Kidney diseases]] | ||
[[Category:Organ failure]] | [[Category:Organ failure]] | ||
[[Category:Causes of death]] | [[Category:Causes of death]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
[[Category:Grammar]] |
Latest revision as of 20:14, 15 October 2014
Acute renal failure Microchapters |
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Treatment |
Case Studies |
Acute renal failure causes On the Web |
American Roentgen Ray Society Images of Acute renal failure causes |
Risk calculators and risk factors for Acute renal failure causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Glomerular filtration rate depends on multiple factors, particularly the renal blood flow. The pressure difference across the renal vasculature i.e the difference in pressure between the renal arterioles and venules is directly proportional to the GFR. Any decrease in renal blood flow, injury to the renal tubules or obstruction to the urinary tract outflow can cause decreased urinary output.
Causes
Common 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
- 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 arrhythmia's
- Congestive heart failure: left ventricular failure, right ventricular failure
- Valvular disorders: severe aortic stenosis
- Severe pulmonary hypertension, massive pulmonary embolism
- 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 -
Renal
- Diseases affecting the renal vasculature -
- Renal arterial obstruction: atherosclerosis, dissecting aneurysm, thrombosis, embolism
- Renal venous obstruction: thrombosis of the veins
- Diseases affecting the renal glomeruli -
- 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
- Vasculitis
- Accelerated hypertension
- Hemolytic uremic syndrome
- Acute tubular necrosis from
- Ischemia - Same causes as for pre-renal failure
- Toxins - Radiocontrast agents, aminoglycosides, cisplatin, acetaminophen, myoglobin from rhabdomyolysis, hemosiderin from hemolysis, light chain immunoglobulins in multiple myeloma, uric acid crystals, etc.
- Interstitial nephritis
- Infections: Acute pyelonephritis, cytomegalovirus infection, etc.
- Allergic: Penicillin's, sulphonamides, rifampin, diuretics, ACE inhibitors
- Infiltration: Malignancies (leukemias and lymphoma's)
- Graft rejection
Post-renal
- Ureteric:
- Ureteric calculi
- Blood clot
- Sloughed renal pappilae
- External compression (retroperitoneal fibrosis)
- Bladder:
- Medication interfering with normal bladder emptying
- Neurogenic bladder
- Benign prostatic hypertrophy or prostate cancer.
- Urethal:
- Obstructed urinary catheter
- Urethral strictures
- Phimosis
- Posterior urethral valve
Causes by Organ System
Causes in Alphabetical Order