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Causes of acute renal failure
Last reviewed: 23.04.2024
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Causes of acute renal failure in newborns
- Prerenal factors (intrauterine dehydration, bleeding, asphyxia, shock, congenital heart defects, congestive heart failure and other conditions leading to hypovolemia and decreased renal perfusion). Prerenal acute renal failure may result from progression to renal renal insufficiency.
- Renal factors (shock, thrombosis of renal vessels, iatrogenic effects in the ante- and postnatal periods).
- Postural obstruction of the urinary tract:
- infection (for example, bilateral blockage of the tuberculosis-ureteric anastomosis with fungal emboli in disseminated candidiasis);
- malformations of the urinary system (valve and stricture of the urethra, ureterocele, obstruction of the ureteral-tuberculosis and ureter-vesicle segments);
- blockade of the urinary tract by salt crystals (urolithiasis can develop even in newborns, especially in prematurity with hypercalciuria).
In newborns, most often (approximately 80-85% of cases), acute renal failure occurs due to the influence of prerenal factors. The main risk factors for the development of acute renal failure in neonatal children: fetal and neonatal hypoxia, generalized infection, hypovolemia and thrombosis of renal vessels. Ischemic injury is the most common cause of acute renal failure. As a result of kidney ischemia, necrosis and apoptosis may develop. Additional factors contributing to the development of necrosis of the kidney tissue can be polypharmacy, the use of nephrotoxic drugs and the overload of protein preparations.
Causes of acute renal failure in the breast and older age
- Diseases and conditions associated with the defeat of the glomerular apparatus of the kidneys (systemic vasculitis, glomerulonephritis, hemolytic-uremic syndrome, posttraumatic shock and in endemic areas - hemorrhagic fever with renal syndrome) leading to the development of renal acute renal failure.
- Prerenal and renal factors (dehydration, bleeding, sepsis, hypoxia, shock, renal vein thrombosis) leading to acute tubular necrosis.
In older age groups in more than 50% of cases, renal factors lead to acute renal failure. 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 likely to develop acute renal failure in response to stressful situations than older children and adults.
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