Common Causes of Acute Kidney Injury
| Prerenal |
| Volume depletion |
| Blood loss |
| GI fluid loss (e.g., vomiting, diarrhea) |
| Overzealous diuretic use |
| Volume overload with reduced renal perfusion |
| Congestive heart failure |
| Low-output with systolic dysfunction |
| “High-output” (e.g., anemia, thyrotoxicosis) |
| Hepatic cirrhosis |
| Severe hypoproteinemia |
| Renovascular disease |
| Drugs |
| NSAIDs, cyclosporine, tacrolimus, ACE inhibitors, ARBs, cisplatin, aminoglycosides |
| Other |
| Hypercalcemia, “third spacing” (e.g., pancreatitis, systemic inflammatory response), hepatorenal syndrome |
| Intrinsic |
| ATN |
| Hypotension or shock, prolonged prerenal azotemia, postoperative sepsis syndrome, rhabdomyolysis, hemolysis, drugs |
| Radiocontrast, aminoglycosides, cisplatin |
| Other tubulointerstitial disease |
| Allergic interstitial nephritis |
| Pyelonephritis (bilateral, or unilateral in single functional kidney) |
| Heavy metal poisoning |
| Atheroembolic disease—after vascular procedures, thrombolysis, or anticoagulation |
| Glomerulonephritis |
|
| Subacute bacterial endocarditis, SLE, cryoglobulinemia (with or without hepatitis C infection), postinfectious GN (classically poststreptococcal) |
| IgA nephropathy and Henoch-Schönlein purpura |
| Glomerular endotheliopathies |
| Thrombotic microangiopathy, malignant hypertension, scleroderma, antiphospholipid syndrome, preeclampsia |
| Postrenal (urinary tract obstruction) |
| Bladder neck obstruction, bladder calculi |
| Prostatic hypertrophy |
| Ureteral obstruction due to compression |
| Pelvic or abdominal malignancy, retroperitoneal fibrosis |
| Nephrolithiasis |
| Papillary necrosis with obstruction |
Abbreviations: ANCA, antineutrophil cytoplasmic antibody; ARBs, angiotensin receptor blockers; ATN, acute tubular necrosis; GBM, glomerular basement membrane; GN, glomerulonephritis; GPA, granulomatosis with polyangiitis; PAN, polyarteritis nodosa.