Prerenal azotemia is an abnormally high level of nitrogen waste products in the blood.
Azotemia - prerenal; Uremia; Renal underperfusion
Prerenal azotemia is common, especially in people who are in the hospital.
The kidneys filter the blood. They also make urine to remove waste products. When the amount, or pressure, of blood flow through the kidney drops, filtering of the blood also drops. Or it may not occur at all. Waste products stay in the blood. Little or no urine is made, even though the kidney itself is working.
When nitrogen waste products, such as creatinine and urea, build up in the body, the condition is called 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 people. Any condition that reduces blood flow to the kidney may cause it, including:
Conditions that allow fluid to escape from the bloodstream
Prerenal azotemia can be reversed if the cause can be found and corrected within 24 hours. If the cause is not fixed quickly, damage may occur to the kidney (acute tubular necrosis).
Complications may include:
Acute kidney failure
Acute tubular necrosis (tissue death)
When to Contact a Medical Professional
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of prerenal azotemia.
Quickly treating any condition that reduces the volume or force of blood flow through the kidneys may help prevent prerenal azotemia.
Goldfarb DA, Poggio ED. Etiology, pathogenesis, and management of renal failure. In: Wein AJ, Kavoussi LR, Novick AC, et al., eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 43.
Meyer TW, Hostetter TH. The pathophysiology of uremia. In: Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 53.
Charles Silberberg, DO, private practice specializing in nephrology; affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.