can be caused by hypovolemia from any cause, cardiac dz, vascular or thrombotic disorders, glomerular diseases, diseases affecting the renal tubules, dephrotoxic drugs, anotomic problems of the GU tract.
Nitrogen wastes will build up in serum. volume overload, htn. pulmonary edema, mentals status changes, n/v, bone and joint promblems, anemia, and increased susceptibility to infx.
- Chem 7, BUN, Cr, electrolytes
- Urinary sodium and creatinine and osmolality
Pre renal, renal or post renal
- Pre renal- intravascular volume should be resotred with normal saline or LR soln.
- If cardiac failure is causing prerenal azotemia cardiac should be optimizied to improve renal perfusion
- Renal failure (intrinsic)- IV fluids, ischemia or nephrotoxic are most commoncauses of intrinsic renal failure.
- 1. low dose dopamine may improve renal blood flow and urine output (not shown to lower mortality rates or improve recovery)
- 2. renally cleared drugs should be used with caution
- post renal failure
- 1. foley catheter
- 2.percutaneaous nephrotostomy