Prerenal Acute Renal Failure

Topic Overview

Prerenal acute renal failure (ARF) occurs when a sudden reduction in blood flow to the kidney (renal hypoperfusion) causes a loss of kidney function. In prerenal acute renal failure, there is nothing wrong with the kidney itself.

Prerenal acute renal failure is the most common type of acute renal failure, accounting for about 55 out of 100 acute renal failure cases.1 It can be a complication of almost any disease, condition, or medicine that causes a decrease in the normal amount of blood and fluid in the body.

Causes of prerenal acute renal failure include:

  • Severe blood loss and low blood pressure related to major cardiac or abdominal surgery, severe infection (sepsis), or injury.
  • Medicines that interfere with the blood supply to the kidneys. Medicines such as ACE inhibitors and common pain medicines (NSAIDs) commonly cause prerenal acute renal failure in people who already have an increased risk for kidney problems.
  • Severe dehydration caused by excessive fluid loss.
  • Severe burns.
  • Pancreatitis and liver diseases, such as cirrhosis, that create fluid shifts in the abdomen.

Treatment focuses on correcting the cause of the prerenal acute renal failure. Depending on the cause, the condition often reverses itself within a couple of days after normal blood flow to the kidneys has been restored. But if it is not reversed or treated successfully and quickly, prerenal acute renal failure can cause tissue death in the kidneys and lead to intrinsic (intrarenal) acute renal failure.

Related Information

References

Citations

  1. Liu KD, Chertow GM (2008). Acute renal failure. In AS Fauci et al., eds., Harrison's Principles of Internal Medicine, 17th ed., vol. 2, pp. 1752–1761. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Tushar J. Vachharajani, MD, FASN, FACP - Nephrology
Last Revised May 10, 2011

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