Postrenal Kidney Injury
The majority of AKI can be fixed by “a bag of LR & a Foley Catheter”… tincture of time may be all that’s necessary in many other cases - Joel Topf MD
HWN Suggests
Acute Kidney Injury
Obstruction is rare, but this is a must-not-miss diagnosis...
The gold standard is bedside ultrasonography of the bladder and kidneys. Simply performing bladder ultrasound is probably adequate, since this may evaluate for urethral obstruction. Unilateral ureteral obstruction shouldn't cause oliguria, due to urine production from the contralateral kidney. Trouble-shooting the Foley catheter (via flushing) is reasonable, but not infallible.
Articles of Interest
Is Postrenal Acute Renal Failure Possible in the Absence of Hydronephrosis?
In conclusion, postrenal ARF must be ruled out in patients with acute anuria, especially zero urine, even if hydronephrosis delinea. Non-contrast spiral abdominal CT is the most suitable tool for diagnosis of these cases. If postrenal ARF is diagnosed and treated quickly, the outcomes will be excellent.
Post-renal acute renal failure
The most common cause of post-renal acute renal failure (ARF) in men is benign prostatic hyperplasia. When treating patients with post-renal ARF, failure of therapy for the usual causes should prompt an investigation for less common etiologies.
Postrenal Acute Kidney Injury
Postrenal acute kidney injury, which used to be called acute renal failure, occurs when an obstruction in the urinary tract below the kidneys causes waste to build up in the kidneys. It is not as common as intrinsic acute kidney injury (AKI) or acute tubular necrosis (ATN).
Acute Kidney Injury (AKI)
Post-renal AKI is associated with an obstructive pathology leading to congestion of the kidneys. Causes of post-renal AKI can be divided anatomically:
Acute Kidney Injury – A Simple Emergency Approach to AKI
Post-renal AKI is caused by urologic obstruction to urine flow. It’s important to measure a post-void residual in all patients with an AKI. The most common causes are BPH and urethral catheter obstruction. Imaging to rule out an obstructive cause should not be performed in every patient with AKI NYD.
CRACKCast E097 – Renal Failure
Intrarenal and Ureteral Causes: Kidney stone. Sloughed papilla. Malignancy. Retroperitoneal fibrosis. Uric acid, oxalic acid, or phosphate crystal precipitation. Sulfonamide, methotrexate, acyclovir, or indinavir precipitation.
Kidney Boy on Acute Kidney Injury: Myths & Musings
Post-Renal: Malignancy (ex: cervical cancer in women, prostate cancer in men), BPH, a kidney stone in a solitary kidney or retroperitoneal fibrosis.
