ACUTE RENAL FAILURE

Acute Renal Failure Acute decrease in Glovmerular Filtration Rate (GFR) Pre-renal (FeNA < 1% bland urine sediment) Shock eg. Hypovolemia decreased cardiac output etc. Renovascular Thrombi Emboli Hepatorenal syndromes Renal (FeNa > 2%) Urinalysis urine microscopy, CBC Sterile pyuria eosinophiluria epithelial casts tubular/interstitial acure tubular necrosis (ATN) (eg severe hypotension drugs myoglobin) Acute interstitial nephritis (eg infections immune mediated) tubular obstruction (eg stones) active sediment: RBC casts dysomorphic RBCs proteinuria glomerular immune-complex deposition (IgA nephropathy, post-infectious, lupus) antibody mediated (anti-GBM antibodies) anti GBM / goodpastures pauci-immune (+ANCA) granulomatosis with polyangitis polyarteritis nodosa henoch schonlein purpura hemolytic uremic syndrome