急性肾功能衰竭系指肾小球滤过率骤然(通常为一过性)降低,可伴有或不伴有少尿。梗阻、肾脏灌注减少、各种肾小球肾炎、脉管炎或毒素等可促使这种情况的发生。本文主要讨论由“急性肾小管坏死”引起的急性实质性肾功能衰竭。但在组织学或功能检查时未必能证实有急性肾小管坏死。急性肾功能衰竭分为肾前性、肾性和肾后性。肾后性肾功能衰竭可归咎于梗阻。无尿且腹部平片肾脏正常或增大通常提示梗阻。急性肾小球肾炎、肾皮质坏死或两侧肾动脉血栓栓塞亦可引起无尿。在急性肾小管坏死的最初12～24小时可出现无尿。无尿和多尿交替出现 Acute renal failure means a sudden (usually transient) reduction of glomerular filtration rate with or without oliguria. Obstruction, decreased renal perfusion, a variety of glomerulonephritis, vasculitis or toxins can contribute to this situation. This article focuses on acute essential renal failure caused by “acute tubular necrosis.” However, histological or functional examination may not be able to confirm acute tubular necrosis. Acute renal failure is divided into prerenal, renal and post-renal sex. Renal renal failure can be attributed to obstruction. Anuria and abdominal plain kidney normal or increased usually prompted obstruction. Acute glomerulonephritis, renal cortical necrosis or bilateral renal artery thromboembolism can also cause anuria. In the first 12 to 24 hours of acute tubular necrosis, there may be no urine. Anuria and polyuria appear alternately