Table 2.

Cause of acute renal failure in patients with cirrhosis

Prerenal causes
    intravascular volume depletion and hypotension
    gastrointestinal fluid loss (nasogastric suction) or pooling of fluid (pancreatitis, bowel disease)
    trauma, surgery, burns
Decreased effective intravascular volume
    congestive heart failure or other causes of myocardial failure
    nephrotic syndrome, infection caused by spontaneous bacterial peritonitis
HRS types 1 and 2
Anaphylaxis
Anesthetic agents
Renal artery or renal vein occlusion by thrombosis; atheroembolism
Intrinsic causes
    tubular necrosis
    ischemic (as a consequence of above-mentioned prerenal events)
    toxic as a result of drugs, organic solvents (carbon tetrachloride, ethylene glycol), heavy metals (mercury, cisplatin), heme pigments (rhabdomyolysis), myeloma light chain
Interstitial nephritis related to drugs, infection, cancer, or sarcoidosis
Postrenal causes
    upper urinary tract obstruction: Ureteral obstruction of one or both kidneys
    lower urinary tract obstruction: Bladder-outlet obstruction