Pre-renal azotemia

Abstract

• Azotemia = increased concentration of non-protein nitrogenous waste products, ie urea and creatinine, in the blood.

• Pre-renal azotemia = azotemia due to inadequate renal perfusion.

• Pre-renal azotemia may be present concurrently with primary renal and post-renal azotemia.

• Cause: decreased renal perfusion, may be caused by dehydration, reduced cardiac output, hemorrhagic shock, etc.

• Signs: dependent on underlying cause but often include vomiting, lethargy, anorexia, diarrhea, etc.

• Diagnosis: elevated serum BUN and creatinine with urine specific gravity >1.035.

• Treatment: treat underlying cause.

• Prognosis: reversible if treated early; longstanding decreased renal perfusion → renal parenchymal damage.