The underlying cause of prerenal acute kidney injury is the reduction of effective circulating blood volume and the decrease of renal perfusion pressure caused by various factors, so that the glomerulus cannot maintain sufficient filtration rate, specifically including blood volume reduction, cardiac output reduction, peripheral vasodilation, severe renal vasoconstriction, and mechanical atresia of renal artery.
1. Decreased blood volume: extracellular fluid loss, mainly caused by burns, diarrhea, vomiting, diuretics, gastrointestinal bleeding, and extracellular fluid retention, mainly caused by pancreatitis, burns, crush syndrome, trauma, nephrotic syndrome, malnutrition, and liver failure.
2. Reduced cardiac output: cardiac insufficiency such as myocardial infarction, arrhythmia, ischemic heart disease, cardiomyopathy, valvular disease, hypertension, severe pulmonary heart disease.
3. Peripheral vasodilation: antihypertensive drugs, sepsis, others (adrenocortical insufficiency, hypomagnesemia, hypercapnia, hypoxemia).
4. Severe renal vasoconstriction: drugs (non-steroidal anti-inflammatory drugs, beta-blockers), hepatorenal syndrome.
5. Mechanical atresia of renal arteries: thrombus, other (embolization, trauma such as angioplasty).
It is recommended that patients with prerenal acute kidney injury should seek timely hospital consultation and cooperate with doctors for diagnosis and treatment.