Vascular Causes Of Acute Renal Failure

Arterial

Venous

Large vessels

Occlusion

Renal artery stenosis

Clot

Thrombosis

Tumor

Cross-clamping

Emboli

Atheroemboli

Endocarditis

Atrial fibrillation

Mural thrombus

Tumor

Small vessels

Cortical necrosis malignant hypertension

Scleroderma

Vasculitis

Antiphospholipid syndrome

Thrombotic microangiopathies

Hemolytic-uremic syndrome

Thrombotic thrombocytopenic purpura

Postpartum

Medications (mitomycin C, cyclosporine, tacrolimus)

Vascular causes of acute renal failure (ARF). Once prerenal and postrenal causes of ARF have been excluded, attention should be focused on the kidney. One useful means of classifying renal causes of ARF is to consider the anatomic compartments of the kidney. Thus, disorders of the renal vasculature (see Fig. 12-18), glomerulus (see Fig. 12-19), interstitium (see Fig. 12-20) and tubules can all result in identical clinical pictures of ARF [1]. This figure depicts the disorders of the renal arterial and venous systems that can result in ARF [15].

History

Examination

Laboratory/Other

Factors that predispose to vascular disease

Marked hypertension

Thrombocytopenia

(smoking, hypertension, diabetes mellitus,

Atrial fibrillation

Microangiopathic hemolysis

hyperlipidemia)

Scleroderma

Coagulopathy

Claudication, stroke, myocardial infarction

Palpable purpura

Urinalysis with hematuria and

Surgical procedure on aorta

Abdominal

low-grade proteinuria

Catheterization procedure involving aorta

aortic aneurysm

Abnormal renal isotope scan

Selected clinical states (scleroderma, pregnancy)

Diminished pulses

and/or Doppler ultrasonography

Selected medications, toxins (cyclosporine,

Infarcted toes

Renal angiography

mitomycin C, cocaine, tacrolimus)

Hollendhorst plaques

Renal or extrarenal tissue analysis

Constitutional symptoms

Vascular bruits

Stigmata of

bacterial endocarditis

Illeus

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

Get My Free Ebook


Post a comment