Acute renal failure causes: Difference between revisions
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==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. | [[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 | ===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. | ||
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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]] | ||
| Line 21: | Line 21: | ||
** 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]] | ||
| Line 40: | Line 40: | ||
** [[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]] | ||
| Line 76: | Line 76: | ||
** [[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''' | ||
| Line 93: | Line 93: | ||
|-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" | ||
| Line 305: | Line 305: | ||
{{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]] | [[Category:Grammar]] | ||
Latest revision as of 20:14, 15 October 2014
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Acute renal failure Microchapters |
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Diagnosis |
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Acute renal failure causes On the Web |
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American Roentgen Ray Society Images of Acute renal failure causes |
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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