Prerenal azotemia is a serious blood disorder caused by reduced blood flow to the kidneys, leading to high levels of toxic waste products in the blood. Symptoms include decreased alertness, fatigue, and reduced urine output. Treatment involves correcting the underlying cause and may include dialysis or transfusions. Early treatment is crucial to prevent permanent kidney damage.
People with prerenal azotemia have an abnormally high level of nitrogenous waste products such as urea and creatinine in their blood. These types of wastes are potentially toxic when present in the blood in large quantities, so this condition can be serious. Prerenal azotemia is a common blood disorder in people who have been hospitalized due to kidney failure or conditions that affect blood flow to the kidneys such as burns, dehydration, bleeding, and chronic diarrhea or vomiting.
Along with the liver, the kidneys are instrumental in filtering the blood and removing potentially harmful substances. If blood flow to the kidneys is reduced, the ability of the kidneys to filter blood is also impaired. Wastes and toxins that would normally be removed remain in the blood and urine output is severely reduced, leading to abnormal fluid retention. When blood levels of urea and creatinine are abnormally high, as in prerenal azotemia, these toxic substances can impair organ function and damage tissue.
Common symptoms of azotemia include decreased alertness, confusion, fatigue, and thirst. People with this condition are also likely to have decreased urine output, dry mouth, pale skin, swelling caused by fluid retention, increased nighttime urination, and rapid pulse. Other possible symptoms include abdominal pain, low blood pressure, dry mucous membranes and reduced skin elasticity.
This condition is usually diagnosed based on blood tests for creatinine and urea, as well as tests to check the levels of creatinine and sodium in the urine. Additionally, kidney function tests and blood osmality tests may be done. The blood osmality test checks the concentration of all particles in the blood and is done to evaluate the body’s fluid balance, which is influenced by hydration levels and kidney function.
The main goal in treating prerenal azotemia is to correct the cause of the imbalance as quickly as possible in order to prevent permanent damage to the kidneys. Treatment often includes one or more dialysis sessions to reduce the toxin load in the blood. If the cause of the condition is blood or fluid loss, treatment may include a transfusion of blood or blood products or the administration of other intravenous fluids to restore blood volume and improve nitrogenous waste balance in the blood.
When the cause of the azotemia can be treated quickly and successfully, the condition can be reversed and permanent kidney damage can be prevented. For treatment to be successful, however, it usually must be given within 24 hours of the first signs of azotemia appearing. Prerenal azotemia may be complicated by acute renal failure or acute tubular necrosis. The latter condition occurs when the kidney tissue begins to die, so it is associated with permanent and irreversible kidney damage.
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