Acute Prerenal Failure

Aka: Acute Prerenal Failure, Prerenal Failure, Prerenal Uremia Syndrome

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II. Epidemiology

  1. Accounts for 50-70% of all Acute Renal Failure

III. Causes

  1. See Prerenal Failure Causes
  2. See Medication Causes of Prerenal Failure

IV. Pathophysiology

  1. Reduced Cardiac Output and renal perfusion pressure (shock states)
  2. Results in afferent arteriole constriction
  3. Avid Sodium and Water reabsorption
  4. Oliguria
  5. Acute Tubular Necrosis if prolonged hypoperfusion

V. Signs

  1. Impaired Cardiac Output
    1. Neck vein distention
    2. Rales
    3. Gallup Rhythm
    4. Pedal edema
  2. Orthostatic Blood Pressure and pulse changes
  3. Weight loss
  4. Decreased fluid intake
  5. Decreased Urine Output

VI. Diagnostics

  1. Empiric volume replacement
  2. Invasive cardiac monitoring

VII. Labs

  1. See Renal Function
  2. Urine Sediment
    1. Normal sediment
    2. Hyaline Casts
    3. Granular Casts

VIII. Management

  1. See Acute Kidney Injury Management

IX. Prognosis

  1. See Acute Kidney Injury Prognosis

X. Prevention

  1. See Prevention of Kidney Disease Progression

XI. Resources

  1. Acute Kidney Injury Guidelines
    1. http://www.renal.org/clinical/guidelinessection/AcuteKidneyInjury.aspx

XII. Reference:

  1. Anderson (8/15/1993) Hospital Practice, p. 61-75
  2. Meyer (2007) N Engl J Med 357(13): 1316-25 [PubMed]
  3. Rahman (2012) Am Fam Physician 86(7): 631-9 [PubMed]
  4. Singri (2003) JAMA 289(6):747-51 [PubMed]

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Related Studies

Ontology: Prerenal uremia syndrome (C0554309)

Concepts Disease or Syndrome (T047)
ICD10 R39.2
SnomedCT 55655006, 445646001
English PRERENAL AZOTEMIA, Prerenal renal failure, Prerenal uraemia, Azotemia prerenal, Prerenal uremia, Azotaemia, Azotaemia due to inadequate renal perfusion, Azotemia due to inadequate renal perfusion, Prerenal azotemia, Prerenal azotaemia, Prerenal azotemia (disorder), Azotemia, azotemia, azotaemia, azotemia prerenal, prerenal azotemia, Prerenal uremia syndrome (disorder), Blum's syndrome, Extrarenal uremia syndrome, Extrarenal uraemia syndrome, Prerenal uraemia syndrome, Azotaemia prerenal, Prerenal uremia syndrome, prerenal; uremia, uremia; prerenal
Dutch azotemie prerenaal, prerenale azotemie, prerenaal; uremie, uremie; prerenaal
French Azotémie prérénale
German praerenale Azotaemie, Azotaemie praerenal
Italian Azotemia pre-renale
Portuguese Azotemia pré-renal
Spanish Azotemia prerenal, Azotemia prerrenal, azoemia prerrenal (trastorno), azoemia por perfusión renal inadecuada, azoemia prerrenal, síndrome urémico extrarrenal, síndrome urémico prerrenal, síndrome urémico prerrenal (trastorno), síndrome de Blum, azotemia prerrenal, azotemia
Japanese 腎前性高窒素血症, ｼﾞﾝｾﾞﾝｾｲｺｳﾁｯｿｹｯｼｮｳ, ｼﾞﾝｾﾞﾝｾｲｺｳﾁｯｿｹﾂｼｮｳ
Czech Prerenální azotemie
Hungarian Praerenalis azotaemia
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Acute prerenal failure (C1167654)

Concepts Disease or Syndrome (T047)
French Défaillance rénale aiguë fonctionnelle
Italian Insufficienza acuta pre-renale
Japanese 急性腎前性腎不全, ｷｭｳｾｲｼﾞﾝｾﾞﾝｾｲｼﾞﾝﾌｾﾞﾝ
Czech Akutní prerenální selhání
Hungarian Acut praerenalis elégtelenség
English Acute prerenal failure
Portuguese Insuficiência pré-renal aguda
Spanish Fallo prerenal agudo
Dutch acuut pre-nierfalen
German akute praerenale Insuffizienz
Derived from the NIH UMLS (Unified Medical Language System)

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