Prerenal Acute Kidney Injury

Acute kidney injury (AKI) is defined as a decrease in kidney function occurring in the glomerular filtration ability of the kidney causing an increase in nitrogenous waste in the blood and in turn increasing the creatinine and blood urea nitrogen levels (McCance & Huether, 2014). Other findings associated with AKI include, a decrease in urinary output and also accumulation of metabolic acids, and increased potassium and phosphate concentrations (Bellomo, Kellum & Ronco, 2012). The AKI is classified as prerenal, intrarenal and postrenal. Prerenal acute kidney injuries are common and are often the result of a reduction in the blood volume leading to hypoperfusion of the kidneys. With extended time in a hypovolemic state the kidneys are unable to maintain a glomerular filtration rate (GFR) despite a compensatory response leading to a decreased filtration rate and pressure (McCance & Huether, 2014). Examples of prerenal injury are renal artery thrombosis or hypotension secondary to hypovolemia caused by dehydration or hemorrhage in addition to shock either septic or cardiogenic (McCance &Huether, 2014). There the possibility …show more content…
The most common cause of the intrarenal injury is secondary to surgery but may also be caused by severe sepsis, obstetric complications, or trauma like burns. During these events a reduction in ATP occurs within the cells creating oxygen free radicals as a result of anaerobic metabolism causing cellular injury, swelling and eventually necrosis. This in turn activates the inflammaorty process the release of cytokines causing tubular injury. Furthermore, the transport of sodium and molecules is disrupted by damage to the proximal tubular epithelium (McCance & Huether,