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What are the causes of acute renal failure

2017-03-14 15:43

The etiology of acute renal failure is various, which can be pided into three categories: pre renal, renal and post renal. The common causes of prerenal ARF include reduced blood volume (such as a variety of causes of fluid loss and bleeding), effective arterial blood volume reduction, low cardiac output, renal hemodynamic change (including renal vasoconstriction and dilatation imbalance) and renal artery mechanical obstruction etc..

1 pre renal acute renal failure

Prerenal acute renal failure is also known as prerenal azotemia, incidence of acute renal failure in 55% ~ 50%, the fundamental causes of prerenal acute renal failure is caused by various factors of effective circulating blood volume reduction, resulting in decreased renal perfusion pressure, glomerular filtration can not keep enough rate and tissue integrity of the renal parenchyma without damage.

A common cause of prerenal acute renal failure, one of the most common may be dehydration, bleeding, shock and heart failure, due to dehydration or blood loss caused by prerenal azotemia can be treated by simple expansion, and often under stress, when the extracellular fluid volume large expansion, such as in liver failure, nephrotic syndrome and heart failure, may cause prerenal azotemia due to insufficient arterial filling, prerenal acute renal failure associated with heart failure, need to pay attention to the dosage of diuretics.

To reduce the load on the heart and the injection of vasoconstrictor drugs, thereby improving renal perfusion pressure, when prerenal acute renal failure and liver failure occurs is particularly difficult to treat, such as too aggressive use of diuretics, are very prone to acute tubular necrosis (ATN) or hepatorenal syndrome (HRS), liver and kidney the syndrome is particularly severe azotemia in the kidney, the renal vasoconstriction caused by expansion and cardiac filling cannot be reversed, but the contraction could be reversed by the hepatorenal syndrome in patients with renal transplantation to a patients with good liver function, liver and kidney syndrome can also be reversal of liver transplantation through its complexity so as can be imagined.

2 renal acute renal failure

Renal acute renal failure is caused by renal parenchymal lesions, including glomerular, tubulointerstitial and renal vascular lesions, the incidence of acute renal failure of 35% ~ 40%.

According to the etiology and pathological changes, renal failure caused by acute renal failure can be pided into two types of kidney and kidney deficiency type:

(1) nephrotoxic type:

The most common reasons of heavy metals, X-ray contrast agents, antibiotics, sulfa drugs, insecticide, biological toxicity etc..

(2) renal deficiency type:

The most common reason is: the amount of blood circulation due to trauma, bleeding, surgery, burns, septic shock, anaphylactic shock and reduce the; renal vascular and renal lesions, such as glomerulonephritis, acute interstitial nephritis, toxemia of pregnancy, epidemic hemorrhagic fever, renal artery embolism; the vascular contraction substances such as burns, crush injury, hemoglobin, myoglobin and other direct vasoconstriction.

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