Renal response to shock

When the MAP decreases below approximately 75 mm Hg, renal autoregulatory processes are no longer effective. Decreased renal blood flow often leads to ATN and its related uremic syndrome. The patient with ATN typically experiences four successive phases as the ATN progresses and then eventually resolves. During the oliguricanuric phase of ATN, multiple organ systems and physiologic processes are affected by the alterations occurring as the result of severely altered renal function. With appropriate treatment, such as fluid-electrolyte and acid-base control, nutritional support, and renal replacement therapy, a return to normal renal function is often possible.