Table 3.

Pathophysiologic factors in ARFa

PreoperativeIntraoperativePostoperative
Lack of renal reserveDecreased renal perfusionSystemic inflammation
Renovascular disease    hypotensionReduced LV function
Prerenal azotemia    lack of pulsatile flowVasoactive agents
    recent diuresis    vasoactive agentsHemodynamic instability
    NPO status    anesthetic effectsNephrotoxins
    impaired LV functionEmbolic eventsVolume depletion
ACEI/ARBCPB-induced inflammationSepsis
NephrotoxinsNephrotoxins
    intravenous contrast    free hemoglobin
    other medications
Endotoxemia
Inflammation
  • a ARF, acute renal failure; NPO, nothing by mouth.