Topic Overview

Pre-renal acute kidney injury (AKI), which used to be called acute renal failure, occurs when a sudden reduction in blood flow to the kidney (renal hypoperfusion) causes a loss of kidney function. In pre-renal acute kidney injury, there is nothing wrong with the kidney itself.

Pre-renal acute kidney injury is the most common type of acute kidney injury. It can be a complication of almost any disease, condition, or medicine that causes a decrease in the normal amount of blood and fluid in the body.

Causes of pre-renal acute kidney injury include:

  • Severe blood loss and low blood pressure related to major cardiac or abdominal surgery, severe infection (sepsis), or injury.
  • Medicines that interfere with the blood supply to the kidneys. Medicines such as ACE inhibitors and common pain medicines (NSAIDs) commonly cause pre-renal acute kidney injury in people who already have an increased risk for kidney problems.
  • Severe dehydration caused by excessive fluid loss.
  • Severe burns.
  • Pancreatitis and liver diseases, such as cirrhosis, that create fluid shifts in the abdomen.

Treatment focuses on correcting the cause of the pre-renal acute kidney injury. Depending on the cause, the condition often reverses itself within a couple of days after normal blood flow to the kidneys has been restored. But if it is not reversed or treated successfully and quickly, pre-renal acute kidney injury can cause tissue death in the kidneys and lead to intrinsic (intrarenal) acute kidney injury.

Related Information


ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Brian D. O'Brien, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Tushar J. Vachharajani, MD, FASN, FACP - Nephrology

Current as ofNovember 20, 2015