Prerenal: Differential

• Intravacular Volume depletion:

• Hemorrhage: Traumatic, Surgical, Dissection

• Decrease intake

• • GI losses: Vomiting, Diarrhea
  • 3rd Spacing: Ascities, Pancreatitis
  • Renal losses: Diuretics, Osmotic Diuresis, DI
  • Cutaneous losses: Burns, Stevens-Johnson syndrome
  • Decreased Oncotic Pressure: Malnutrtition, Cirrhosis, Nephrotic Syndrome, Proetein loosing
  • enteropathy

• Decreased effective intravascular volume

• Decreased Cardiac output:

• Arrythmia

• • Heart failure: Dilated, Hyprtrophic, Restrctive, Constrictive, Diastolic
  • Valvular Heart Disease
  • ACS
  • Myocardial rupture
  • Tamponode
  • Pulmonary embolus
  • Pneumothorax

• Systemic vasodilation

• • Sepsis
  • Neurogenic
  • Anaphylaxis
  • Anesthetics
  • Drug overdose
  • Hypoxia
  • Acidosis
  • Adrenal Insufficiency

• Renal Artery: RAS ( Fibromuscular, Atherosclerotic), Embolic, Dissection

• Afferent arteriolar vasoconstriction

• • Hypercalcemia
  • Drugs (NSAIDs, amphotericin B, calcineurin inhibitors, norepinephrine, radiocontrast agents)
  • Hepatorenal syndrome

• Efferent arteriolar vasodilation – ACEI or ARB