Long-Term Care

Prerenal Azotemia: Causes, signs, and symptoms

LTC Nursing Assistant Trainer, January 12, 2012

Prerenal azotemia is the most common form of kidney failure seen in hospitalized patients. Long-term care facility residents are commonly diagnosed with prerenal azotemia, particularly if they have been diagnosed with dehydration. With prerenal azotemia, inadequate perfusion of the kidneys occurs as a result of extracellular fluid volume depletion or cardiovascular disease.

The build-up of nitrogen waste products and accumulation of excess fluid in the body are responsible for most of the symptoms of prerenal azotemia. Common causes of this condition are:

  • Dehydration (most common cause)
  • Conditions in which the heart cannot pump sufficient blood
  • Heart failure
  • Vomiting
  • Diarrhea
  • Bleeding
  • Burns

Signs and symptoms of prerenal azotemia include the following:

  • Reduced urine production; little or no urine produced
  • Confusion and decreased alertness that progressively worsens
  • Thirst
  • Edema
  • Abdominal pain
  • Rapid pulse
  • Dry mouth
  • Increased urination at night
  • Signs or symptoms of infection elsewhere in the body

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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