Hypovolemia
GI: decreased intake, vomiting and diarrhea
Hemorrhage
Pharmacologic: diuretics
Third spacing
Pancreatitis
Skin losses: hyperthermia, burns
Miscellaneous
Hypoaldosteronism
Salt-losing nephropathy
Postobstructive diuresis
Hypotension
Sepsis
Decreased cardiac output: decompensated heart failure, tamponade, massive pulmonary embolus
Hepatorenal Syndrome
Ischemia/infarction
Valvulopathy
Pharmacologic
Beta-blockers
Calcium-channel blockers
Antihypertensive medications
High output heart failure
Thyrotoxicosis
AV fistula
Renal artery and small-vessel disease
Embolism: thrombotic, septic, cholesterol
Thrombosis: atherosclerosis, vasculitis, sickle cell disease
Dissection
Pharmacologic
NSAIDs
ACEI/ARB
Observed shortly after initiation of therapy
Microvascular thrombosis
Preeclampsia
Hemolytic Uremic Syndrome (HUS)
Thrombotic Thrombocytopenic Purpura (TTP)
Disseminated Intravascular Coagulation (DIC)
Vasculitis
Sickle Cell Disease
Hypercalcemia
GI: decreased intake, vomiting and diarrhea
Hemorrhage
Pharmacologic: diuretics
Third spacing
Pancreatitis
Skin losses: hyperthermia, burns
Miscellaneous
Hypoaldosteronism
Salt-losing nephropathy
Postobstructive diuresis
Pancreatitis
Hypoaldosteronism
Salt-losing nephropathy
Postobstructive diuresis
Sepsis
Decreased cardiac output: decompensated heart failure, tamponade, massive pulmonary embolus
Hepatorenal Syndrome
Ischemia/infarction
Valvulopathy
Pharmacologic
Beta-blockers
Calcium-channel blockers
Antihypertensive medications
High output heart failure
Thyrotoxicosis
AV fistula
Ischemia/infarction
Valvulopathy
Beta-blockers
Calcium-channel blockers
Antihypertensive medications
Thyrotoxicosis
AV fistula
Embolism: thrombotic, septic, cholesterol
Thrombosis: atherosclerosis, vasculitis, sickle cell disease
Dissection
Pharmacologic
NSAIDs
ACEI/ARB
Observed shortly after initiation of therapy
Microvascular thrombosis
Preeclampsia
Hemolytic Uremic Syndrome (HUS)
Thrombotic Thrombocytopenic Purpura (TTP)
Disseminated Intravascular Coagulation (DIC)
Vasculitis
Sickle Cell Disease
Hypercalcemia
NSAIDs
ACEI/ARB
Observed shortly after initiation of therapy
Observed shortly after initiation of therapy
Preeclampsia
Hemolytic Uremic Syndrome (HUS)
Thrombotic Thrombocytopenic Purpura (TTP)
Disseminated Intravascular Coagulation (DIC)
Vasculitis
Sickle Cell Disease
Tubular diseases
Ischemic acute tubular necrosis
Caused by more advanced disease due to the prerenal causes
Nephrotoxins
Aminoglycosides, radiocontrast, amphotericin B, heme pigments (rhabdomyolysis, hemolysis)
Obstruction
Uric acid, calcium oxalate from Ethylene Glycol Toxicity, Multiple myeloma (immunoglobin light chains), amyloidosis
Pharmacologic: sulfonamides, triamterene, acyclovir, indinavir
Interstitial diseases
Acute interstitial nephritis: typically a drug reaction (NSAIDs, Penicillins and antibiotics, Diuretics, phenytoin)
Infection: bilateral pyelonephritis, Legionella, Hantavirus
Infiltrative disease: sarcoidosis, lymphoma
Autoimmune diseases: SLE
Glomerular diseases
Rapidly progressive glomerulonephritis
Goodpasture syndrome, granulomatosis with polyangiitis (Wegener's) HSP, SLE, membranoproliferative GN
Postinfectious glomerulonephritis
Small-vessel diseases
Microvascular thrombosis
Preeclampsia, HUS, DIC, TTP, vasculitis (PAN, SCD, atheroembolism)
Malignant hypertension
Scleroderma
Renal vein thrombosis
Abdominal compartment syndrome
Hepatorenal syndrome
Cardiorenal syndrome
Ischemic acute tubular necrosis
Caused by more advanced disease due to the prerenal causes
Caused by more advanced disease due to the prerenal causes
Aminoglycosides, radiocontrast, amphotericin B, heme pigments (rhabdomyolysis, hemolysis)
Obstruction
Uric acid, calcium oxalate from Ethylene Glycol Toxicity, Multiple myeloma (immunoglobin light chains), amyloidosis
Pharmacologic: sulfonamides, triamterene, acyclovir, indinavir
Uric acid, calcium oxalate from Ethylene Glycol Toxicity, Multiple myeloma (immunoglobin light chains), amyloidosis
Pharmacologic: sulfonamides, triamterene, acyclovir, indinavir
Acute interstitial nephritis: typically a drug reaction (NSAIDs, Penicillins and antibiotics, Diuretics, phenytoin)
Infection: bilateral pyelonephritis, Legionella, Hantavirus
Infiltrative disease: sarcoidosis, lymphoma
Autoimmune diseases: SLE
Rapidly progressive glomerulonephritis
Goodpasture syndrome, granulomatosis with polyangiitis (Wegener's) HSP, SLE, membranoproliferative GN
Postinfectious glomerulonephritis
Goodpasture syndrome, granulomatosis with polyangiitis (Wegener's) HSP, SLE, membranoproliferative GN
Microvascular thrombosis
Preeclampsia, HUS, DIC, TTP, vasculitis (PAN, SCD, atheroembolism)
Malignant hypertension
Scleroderma
Renal vein thrombosis
Preeclampsia, HUS, DIC, TTP, vasculitis (PAN, SCD, atheroembolism)
Infants and children
Urethra and bladder outlet
Anatomic malformations
Urethral atresia
Meatal stenosis
Anterior and posterior urethral valves
Ureter
Anatomic malformations
Vesicoureteral reflux (female preponderance)
Ureterovesical junction obstruction
Ureterocele
Retroperitoneal tumor
All ages
Various locations in GU tract
Trauma
Blood clot
Urethra and bladder outlet
Phimosis or urethral stricture (male preponderance)
Neurogenic bladder
Diabetes mellitus, spinal cord disease, multiple sclerosis, Parkinson's disease
Pharmacologic: anticholinergics, a-adrenergic antagonists, opioids
Adults
Urethra and bladder outlet
BPH
Cancer of prostate, bladder, cervix, or colon
Obstructed catheters
Ureter
Ureteral calculi, uric acid crystals
Papillary necrosis
Sickle cell disease, DM, pyelonephritis
Tumor: Ureter, uterus, prostate, bladder, colon, rectum; retroperitoneal lymphoma
Retroperitoneal fibrosis: idiopathic, tuberculosis, sarcoidosis, propranolol
Stricture: TB, radiation, schistosomiasis, NSAIDs
Miscellaneous
Aortic aneurysm
Pregnant uterus
IBD
Renal or ureter trauma
Urethra and bladder outlet
Anatomic malformations
Urethral atresia
Meatal stenosis
Anterior and posterior urethral valves
Ureter
Anatomic malformations
Vesicoureteral reflux (female preponderance)
Ureterovesical junction obstruction
Ureterocele
Retroperitoneal tumor
Anatomic malformations
Urethral atresia
Meatal stenosis
Anterior and posterior urethral valves
Urethral atresia
Meatal stenosis
Anterior and posterior urethral valves
Anatomic malformations
Vesicoureteral reflux (female preponderance)
Ureterovesical junction obstruction
Ureterocele
Retroperitoneal tumor
Vesicoureteral reflux (female preponderance)
Ureterovesical junction obstruction
Ureterocele
Retroperitoneal tumor
Various locations in GU tract
Trauma
Blood clot
Urethra and bladder outlet
Phimosis or urethral stricture (male preponderance)
Neurogenic bladder
Diabetes mellitus, spinal cord disease, multiple sclerosis, Parkinson's disease
Pharmacologic: anticholinergics, a-adrenergic antagonists, opioids
Trauma
Blood clot
Phimosis or urethral stricture (male preponderance)
Neurogenic bladder
Diabetes mellitus, spinal cord disease, multiple sclerosis, Parkinson's disease
Pharmacologic: anticholinergics, a-adrenergic antagonists, opioids
Diabetes mellitus, spinal cord disease, multiple sclerosis, Parkinson's disease
Pharmacologic: anticholinergics, a-adrenergic antagonists, opioids
Urethra and bladder outlet
BPH
Cancer of prostate, bladder, cervix, or colon
Obstructed catheters
Ureter
Ureteral calculi, uric acid crystals
Papillary necrosis
Sickle cell disease, DM, pyelonephritis
Tumor: Ureter, uterus, prostate, bladder, colon, rectum; retroperitoneal lymphoma
Retroperitoneal fibrosis: idiopathic, tuberculosis, sarcoidosis, propranolol
Stricture: TB, radiation, schistosomiasis, NSAIDs
Miscellaneous
Aortic aneurysm
Pregnant uterus
IBD
Renal or ureter trauma
BPH
Cancer of prostate, bladder, cervix, or colon
Obstructed catheters
Ureteral calculi, uric acid crystals
Papillary necrosis
Sickle cell disease, DM, pyelonephritis
Tumor: Ureter, uterus, prostate, bladder, colon, rectum; retroperitoneal lymphoma
Retroperitoneal fibrosis: idiopathic, tuberculosis, sarcoidosis, propranolol
Stricture: TB, radiation, schistosomiasis, NSAIDs
Miscellaneous
Aortic aneurysm
Pregnant uterus
IBD
Renal or ureter trauma
Sickle cell disease, DM, pyelonephritis
Aortic aneurysm
Pregnant uterus
IBD
Renal or ureter trauma
Acute kidney injury
Acute hepatic failure
Acute urinary retention
Tumor lysis syndrome
Hepatorenal syndrome
Adrenal crisis
Renal infarction
Diabetes insipidus