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Causes of acute renal failure
Last reviewed: 06.07.2025
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Causes of Acute Renal Failure in Newborns
- Prerenal factors (intrauterine dehydration, hemorrhage, asphyxia, shock, congenital heart defects, congestive heart failure and other conditions leading to hypovolemia and decreased renal perfusion). Prerenal acute renal failure may progress to renal renal failure.
- Renal factors (shock, renal vascular thrombosis, iatrogenic effects in the ante- and postnatal periods).
- Postrenal urinary tract obstruction:
- infections (for example, bilateral blockade of the ureteropelvic junction by fungal emboli in disseminated candidiasis);
- malformations of the urinary system (urethral valve and stricture, ureterocele, obstruction of the ureteropelvic and ureterovesical segments);
- blockage of the urinary tract by salt crystals (urolithiasis can develop even in newborns, especially in premature babies with hypercalciuria).
In newborns, acute renal failure most often (approximately 80-85% of cases) occurs due to the effects of prerenal factors. The main risk factors for the development of acute renal failure in children of the neonatal period are: fetal and neonatal hypoxia, generalized infection, hypovolemia and renal vascular thrombosis. Ischemic damage is the most common cause of acute renal failure. As a result of renal ischemia, necrosis and apoptosis may develop. Additional factors contributing to the development of renal tissue necrosis may be polypharmacy, the use of nephrotoxic drugs and protein overload.
Causes of acute renal failure in infancy and old age
- Diseases and conditions associated with damage to the glomerular apparatus of the kidneys (systemic vasculitis, glomerulonephritis, hemolytic uremic syndrome, post-traumatic shock and, in endemic areas, hemorrhagic fever with renal syndrome), leading to the development of acute renal failure.
- Prerenal and renal factors (dehydration, bleeding, sepsis, hypoxia, shock, renal vein thrombosis) leading to acute tubular necrosis.
In older age groups, renal factors lead to acute renal failure in more than 50% of cases. Unlike adults, postrenal oliguria is extremely rare in children (less than 1% of all cases of oliguria development).
It should be noted that due to the functional immaturity of the kidneys, young children are more susceptible to developing acute renal failure in response to stressful situations than older children and adults.
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