Acute Renal Failure (ARF)

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Acute renal failure (ARF), also referred to as acute kidney injury (AKI), is the abrupt loss of

renal function; the kidneys inability to perform its functions of filtering wastes from the blood,

regulating blood pressure, and maintaining electrolyte balance in the body. This sudden loss of

functioning occurs within less. Most patients who experience ARF are already hospitalized or

may be in ICU for other medical conditions, although some patients have no signs or symptoms

but a diagnosis is made from lab results performed for other medical reasons. In most cases,

kidney function can return to normal if the cause of failure is identified and treated.

ARF is classified into the following three categories depending on the causal factors:

• Prerenal ARF results from a rapid decrease in blood pressure or a diminished flow of

blood to the kidneys which may be caused by injury, illness, severe allergic reactions,

acute dehydration, or certain medications that include aspirin, ibuprofen, or naproxen.

• Intrarenal ARF results from damage to the kidneys themselves due to particular

conditions, diseases, or agents including infection, venal and/or arterial blood

clots in proximity of the kidneys, cholesterol deposits that impede blood flow,

glomerulonephritis, toxins such as alcohol and drugs, or various medications including

those used for chemotherapy, antibiotics, dyes used in contrast studies, and zoledronic

acid, prescribed for the treatment of osteoporosis and elevated blood calcium levels.

• Postrenal ARF results from a sudden blockage of the ureters, resulting in the inability

to pass urine from the body. Uropathy can occur with certain cancers such as prostate...

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...s blood from the body where it goes through a dialyzer that cleans and filters

the blood which is then pumped back into the body. This process helps to remove toxins, fluids,

and potassium while the kidneys are recovering. In severe cases, a kidney severely damaged

may require permanent dialysis. Those suffering from chronic kidney disease due to permanent

damage to a kidney may require a kidney transplant.

The short term nursing goals would be to establish and maintain normal levels of fluids and

electrolytes, returning normal kidney function. Also, patient comfort, both physical and mental

need to be addressed and supported. Long term nursing goals would be to educate the patient

and family with regard to possible dietary changes and reduced activity levels, if needed, so a

healthy life style can prevent further occurrences.

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