Prerenal acute kidney injury etiology
- ↓ Effective arterial volume (NEJM 2007;357:797) Hypovolemia, ↓ CO (CHF), ↓ oncotic pressure (cirrhosis, nephrotic), vasodilation (sepsis)
- Δ local renal perfusion: NSAIDs, ACEI/ARB, contrast, calcineurin inhib, HRS, hyperCa
- Large vessel: RAS (bilateral + ACEI), VTE, dissection, abd compart. synd. (renal vs. compress), vasculitis
UA, Sediment, Indices
- Bland
- Transparent hyaline casts
- FENa <1%, BUN/Cr >20
- FEUN ≤35%
Explain by ChatGPT
Prerenal acute kidney injury is caused by a decrease in effective arterial volume, which can be caused by hypovolemia, congestive heart failure, nephrotic syndrome, or sepsis. This decrease in effective arterial volume leads to a decrease in local renal perfusion, which can be caused by nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, contrast agents, calcineurin inhibitors, hemodialysis, or hypercalcemia. Large vessel causes of prerenal acute kidney injury include renal artery stenosis, venous thromboembolism, aortic dissection, or abdominal compartment syndrome.
Urinalysis, sediment, and indices can be used to diagnose prerenal acute kidney injury. Bland urine is urine that does not contain any sediment. Transparent urine contains hyaline casts. The fractional excretion of sodium is the percentage of sodium excreted in the urine divided by the percentage of sodium filtered. The fractional excretion of sodium is less than 1% in prerenal acute kidney injury. The BUN/creatinine ratio is the ratio of the blood urea nitrogen concentration to the creatinine concentration. The BUN/creatinine ratio is less than 35% in prerenal acute kidney injury.
窩的英文不太好
腎前性急性腎損傷是由有效動脈容量減少引起的，這可由低血容量、充血性心力衰竭、腎病綜合徵或敗血症引起。這種有效動脈容積的減少導致局部腎灌注減少，這可能由非甾體類抗炎藥、血管緊張素轉換酶抑製劑或血管緊張素受體阻滯劑、造影劑、神經鈣蛋白抑製劑、血液透析或高鈣血症引起。腎前性急性腎損傷的大血管原因包括腎動脈狹窄、靜脈血栓栓塞、主動脈夾層或腹腔間隔室綜合徵。
尿液分析、沉渣和指標可用於診斷腎前性急性腎損傷。無味尿液是不含任何沉澱物的尿液。透明尿液含有透明管型。鈉排泄分數是尿液中排泄鈉的百分比除以過濾鈉的百分比。在腎前性急性腎損傷中，鈉的排泄分數小於 1%。 BUN/肌酐比值是血尿素氮濃度與肌酐濃度的比值。腎前性急性腎損傷的 BUN/肌酐比值小於 35%。