Prevalence
Causes
Clinical
features
Investigations
Therapy
Prevention
Prognosis
|  | | | Causes |
Causes are commonly multifactorial and often iatrogenic in origin.
c
The commonest causes are
c
-
hypotension
-
multifactorial
-
dehydration
-
sepsis
-
drugs or contrast media
Pre-renal causes
c
-
cardiogenic shock e.g. hypotension from MI, heart failure
-
hypovolaemia
e.g. dehydration,
haemorrhage, surgery
-
sepsis
-
hepatorenal syndrome
-
rhabdomyolysis
-
haemolytic uraemic syndrome (HUS), thrombotic thrombocytopaenic purpura
(TTP)
Renal causes
c
-
acute tubular necrosis due to
ischaemia
(i.e. any pre-renal cause if sufficiently severe or prolonged)
-
acute tubular necrosis due to drugs or toxins (e.g. aminoglycosides, contrast media)
-
acute interstitial nephritis
-
inflammatory
- vasculitis
- glomerulonephriti
- scleroderma
- Goodpasture's syndrome
- vascular
- other causes
- myeloma
- amyloid
- malignant hypertension
Post-renal causes
c
-
obstruction (stones, prostate, tumour)
N.B. Any of the above may coincide with pre-existing chronic renal insufficiency: called acute-on-chronic renal failure.
|
internal medicine