Acute renal failure causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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 (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.