Differential Diagnosis for Hypotension and Poor Kidney Function

Single Most Likely Diagnosis

• Hypovolemic Shock: This condition occurs when there's not enough blood volume in the body, leading to inadequate blood flow and oxygen delivery to vital organs, including the kidneys. It can result from dehydration, bleeding, or severe burns, and is a common cause of both hypotension and acute kidney injury.

Other Likely Diagnoses

• Sepsis: A systemic infection that can cause hypotension due to vasodilation and decreased vascular resistance, as well as impair kidney function through inflammation and decreased perfusion.
• Cardiogenic Shock: This occurs when the heart is unable to pump enough blood to meet the body's needs, often due to heart failure or acute myocardial infarction, leading to hypotension and reduced kidney function.
• Nephrotic Syndrome: A collection of symptoms indicating kidney damage, specifically due to damage to the glomeruli, leading to severe proteinuria, hypoalbuminemia, and edema. Hypotension can occur due to hypoalbuminemia and decreased blood volume.

Do Not Miss Diagnoses

• Adrenal Insufficiency: A condition where the adrenal glands do not produce adequate amounts of hormones, including aldosterone and cortisol, which are crucial for blood pressure regulation and electrolyte balance. It can present with hypotension and may affect kidney function.
• Aortic Dissection: A serious condition where there is a tear in the inner layer of the aorta, which can lead to hypotension if it affects blood flow to major arteries, including those supplying the kidneys.
• Pulmonary Embolism: A blockage of an artery in the lungs that can cause hypotension due to decreased cardiac output and can also impair kidney function due to decreased perfusion.

Rare Diagnoses

• Pheochromocytoma Crisis: A rare tumor of the adrenal gland that can cause episodes of severe hypertension, but in crisis, it can also lead to hypotension due to vasodilation and decreased blood volume.
• Hemolytic Uremic Syndrome (HUS): A disorder that occurs when an infection in the digestive system produces toxic substances that destroy red blood cells, leading to kidney injury and potentially hypotension.
• Vasculitis: Inflammation of the blood vessels that can affect kidney function and blood pressure regulation, though it is less common than other causes of hypotension and kidney dysfunction.