Which of the following would NOT be a cause of prerenal failure?

A. Secretions include amylase: Amylase is a digestive enzyme secreted by the pancreas that helps break down carbohydrates. Elevated serum amylase is a common diagnostic marker in acute pancreatitis.

B. Contains proteolytic enzymes that break down dietary proteins: The pancreas produces proteolytic enzymes like trypsin and chymotrypsin, which digest proteins in the small intestine under normal conditions.

C. Pancreatic enzymes auto-digest pancreatic cells and tissue: In acute pancreatitis, premature activation of these enzymes inside the pancreas leads to self-digestion and inflammation of pancreatic tissue.

D. A reversible inflammatory process: Acute pancreatitis is typically reversible with prompt treatment, unlike chronic pancreatitis which involves permanent structural damage and functional loss.

E. Cardinal manifestation is abdominal pain – could be midabdominal, could be epigastric: Severe abdominal pain is the hallmark symptom, commonly located in the epigastric or midabdominal region and may radiate to the back.

A. Acute renal disease–acute glomerulonephritis: This leads to inflammation and damage of the glomerular basement membrane, impairing filtration and causing intrarenal injury. It often presents with hematuria, proteinuria, and hypertension.

B. Exposure to nephrotoxic drugs, heavy metals, and organic solvents: These substances damage renal tubules through direct toxicity or by causing crystal formation, leading to acute tubular necrosis. Common agents include aminoglycosides and contrast dyes.

C. Prolonged renal ischemia: Sustained low perfusion causes tubular cell death and sloughing, leading to obstruction and decreased GFR. It is often a progression from untreated prerenal AKI.

D. Liver failure: Liver dysfunction reduces renal perfusion and may cause hepatorenal syndrome, but this is classified as prerenal, not intrarenal, in origin. The kidneys are structurally intact but functionally impaired.