Acute Azotemia

Acute azotemia, a sudden increase in the nitrogen-containing compounds in blood (primarily BUN and creatinine), occurs commonly in our veterinary patients. In the emergency setting, many patients will present with severe azotemia, which can be easily diagnosed by evaluation of BUN and creatinine. Acute kidney injury includes the various stages of kidney damage and dysfunction, ranging from early non-azotemic injury to the most severe stage of injury, acute renal failure. It is critical for any clinician to have an understanding of these terms so that kidney disease is diagnosed in a timely manner. Once azotemia is diagnosed, the treating clinician should first determine whether a prerenal, renal or postrenal condition is present. Prerenal and postrenal conditions should be treated accordingly. If renal azotemia is diagnosed, a diagnostic work-up for an underlying cause should be performed. Manifestations of azotemia, such as hyperkalemia and hypertension, should be managed and treated accordingly.