Pathophysiology of acute uremia

Pathophysiology of acute uremia Acute renal failure has traditionally been classified as Pre-renal, intrinsic renal, and/or Post-renal in origin. Careful scrutiny of history, physical examination, laboratory findings and imaging studies of cats presenting with signs of an acute uremic crisis usually provides adequate information to identify Pre-renal, renal and Post-renal components of uremia. Although these categories help establish cause and predict prognosis, they share many pathophysiologic features and are not mutually exclusive. Pre-renal azotemia develops as an adaptive response to any cause of reduced renal perfusion (e.g., hypovolemia, inadequate cardiac output, marked vasodilatation). Initially, nephrons remain intact allowing a rapid return to function once perfusion has been restored. If the patient remains uremic after Pre-renal causes of azotemia are corrected, they should be rapidly and thoroughly evaluated for intrinsic renal and Postrenal causes of azotemia.