Predisposing Factors for Acute Renal Failure

Renal insult

Proteinuria

Renal insult

Proteinuria

Advanced age

Volume depletion

Diuretic use

Previous cardiac or renal insufficiency

Myeloma

Higher probability for ARF

Advanced age

Volume depletion

Diuretic use

Previous cardiac or renal insufficiency

Myeloma

Higher probability for ARF

Very elderly

Elderly

Young

12%

17%

11%

7%

29%

□ Obstructive EH Prerenal

□ Acute tubular

FIGURE 8-11

Factors that predispose to acute renal failure (ARF). Some of them act synergistically when they occur in the same patient. Advanced age and volume depletion are particularly important.

FIGURE 8-12

Causes of acute renal failure (ARF) relative to age. Although the cause of ARF is usually multifactorial, one can define the cause of each case as the most likely contributor to impairment of renal function. One interesting approach is to distribute the causes of ARF according to age. This figure shows the main causes of ARF, dividing a population diagnosed with ARF into the very elderly (at least 80 years), elderly (65 to 79), and young (younger than 65). Essentially, acute tubular necrosis (ATN) is less frequent (P=0.004) and obstructive ARF more frequent (P<0.001) in the very old than in the youngest patients. Prerenal diseases appear with similar frequency in the three age groups. (Data from Pascual et al. [3].)

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