Navigate Up

Seniors Center - A-Z Index

#
Q
Y
Z

Print This Page

Prerenal azotemia

Prerenal azotemia is an abnormally high level of nitrogen waste products in the blood.

Alternative Names

Azotemia - prerenal; Uremia; Renal underperfusion

Causes, incidence, and risk factors

Prerenal azotemia is common, especially in people who are in the hospital.

The kidneys normally filter the blood. When the volume or pressure of blood flow through the kidney drops, filtering of the blood also drops, or may not occur at all. Waste products stay in the blood and little or no urine is formed, even though the kidney itself is working.

Nitrogen waste products, such as creatinine and urea, build up in the body (azotemia). These waste products act as poisons when they build up. They damage tissues and reduce the ability of the organs to function.

Prerenal azotemia is the most common form of kidney failure in hospitalized patients. Any condition that reduces blood flow to the kidney may cause it, including:

  • Burns
  • Conditions that allow fluid to escape from the bloodstream
  • Long-term vomiting, diarrhea, or bleeding
  • Loss of blood volume (such as with dehydration)

Conditions in which the heart cannot pump enough blood or pumps blood at a low volume also increase the risk for prerenal azotemia. These conditions include:

It also can be caused by conditions that interrupt blood flow to the kidney, such as:

Symptoms

Other symptoms may include:

Signs and tests

An examination may show:

The following tests may be done:

Treatment

The main goal of treatment is to quickly correct the cause before the kidney becomes damaged. People often need to stay in the hospital, and may need treatment in an intensive care unit.

Intravenous fluids, including blood or blood products, may be used to increase blood volume. After blood volume has been restored, medications may be used to increase blood pressure and heart output. These may include dopamine , dobutamine, and other heart medications. The cause of the decreased blood volume or blood pressure should be diagnosed and treated.

If the person has other symptoms of acute kidney failure, treatment for it should include:

  • Dialysis , including hemodialysis or dialysis inside the body (peritoneal dialysis)
  • Diet changes
  • Medication

Expectations (prognosis)

Prerenal azotemia can be reversed if the cause can be found and corrected within 24 hours. However, if the cause is not fixed quickly, damage may occur to the kidney (acute tubular necrosis ).

Complications

  • Acute kidney failure
  • Acute tubular necrosis (tissue death)

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of prerenal azotemia.

Prevention

Quickly treating any condition that reduces the volume or force of blood flow through the kidneys may help prevent prerenal azotemia.

References

Yu ASL. Diseases of magnesium and phosphorous. In: Goldman L, Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 121.

Updated: 9/21/2011

Herbert Y. Lin, MD, PhD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com