Prerenal Acute Kidney Injury

Topic Overview

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

Prerenal acute kidney injury is the most common type of acute kidney injury. 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 kidney injury 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 kidney injury 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 kidney injury. 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 kidney injury can cause tissue death in the kidneys and lead to intrinsic (intrarenal) acute kidney injury.