Explain the pathophysiology of acute renal failure. Include pre-renal, intrarenal and postrenal causes.
Acute renal failure is a sudden decrease of kidney function often characterized by the loss of homeostatic equilibrium of the internal medium causing waste accumulation in the blood. Aside from accumulation of waste products like nitrogen and urea, it is also characterized by a sudden decrease of glomerular filtration rate (GFR) which disables the kidney from filtering waste products that is harmful to the body. Evidently, acute renal failure disables the kidney from maintaining fluid and electrolyte balance. As stated by kidneyatlas.org, causes for acute renal failure are classified into three: prerenal, intrarenal, and postrenal.
In prerenal, the glomerular filteration rate falls as a consequence from cardiovascular disease and a decrease of extracellular fluid in the body. According to Merck Manual for healthcare the causes for prerenal are as follows: extracellular volume depletion, low cardiac output, low systemic vascular resistance, increased renal vascular resistance, and decreased efferent arteriolar tone leading to decreased GFR. Intrarenal is classified as a decrease in GFR secondary to intrinsic renal damage affecting tubules, interstitium, and vessels (kidneyatlas.org). While according to Merck Manual the causes are acute tubular injury, acute glomerulonephritis, acute tubulointerstitial nephritis, acute vascular nephropathy, and infiltrative disease. Lastly, postrenal is characterized by obstruction in the urinary tract that frequently leads to renal failure (kidneyatlas.org). It is caused by tubular precipitation, urethral obstruction, and bladder obstruction (merck).
What diagnostic exams would be used to...
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...at the long term goal of treatment is to correct or treat the kidney problem, support the kidneys until they have healed and can work properly, and prevent or treat any complications caused by acute renal failure.
Works Cited
http://www.kidneyatlas.org/book1/adk1_08.pdf
http://merckandcoinc.net/mmpe/sec17/ch233/ch233b.html
http://nursing-management.blogspot.com/2009/07/nursing-care-plan-for-acute-renal.html
http://www.questdiagnostics.com/kbase/topic/major/aa115361/trtover.htm
http://www.aafp.org/afp/2005/1101/p1739.html
http://proquest.umi.com/pqdweb?index=2&did=2048778701&SrchMode=1&sid=10&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1280276550&clientId=94482
http://www.mcw.edu/display/ChronicRenalInsufficiency.htm
http://clinicaltrials.gov/ct2/show/NCT00323713
http://www.livestrong.com/acute-kidney-failure/
http://www.aafp.org/afp/20000401/2077.html
Kidney Care is comprised of U.S. dialysis and related lab services, ancillary services and strategic initiatives, including international operations and corporate administrative support. The U.S. dialysis and related lab services business is the largest line of business, which is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD). The HCP division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of providing coordinated, outcomes-based medical care in a cost-effective manner ("DaVita Healthcare Partners 10-K Annual Report" 2015). STp(c) Segmentation, targeting, and positioning together comprise a three stage process.
There are two types of glomerulonephritis—acute renal failure (ARF) and chronic kidney disease (CKD). The ACF form generally develops suddenly as a result of an infection or illness, such as, group A streptococci bacteria, hepatitis, or in diseases such as lupus or HIV (Mathias, 2013). This type may require dialysis to replace renal function while it lasts, however, kidney function usually returns after the primary illness is treated. Many acute patients will not have any other complications as no permanent damage is done. Whereas CKD is found in a person that has had glomerulonephritis for months to years in some cases and may be asymptomatic until the kidney has become irreversibly damaged. ARF can evolve to become chronic if the glomeruli do not respond to
The kidneys play a major role in the blood composition and volume , the excretion of metabolic wastes in the urine, the control the acid/base balance in the body and the hormone production for maintaining hemostasis. The damages to the GBM in the glomeruli alter filtration process that allows the protein and red blood cells to leak into the urine. Loss of protein like albumin in the urine results in a decrease of their level into the blood stream. Consequently, this patient’s blood reveals a decreased albumin (Alb) value of 2.9 g/dL, decreased serum total protein value of 5 .0 g/dL and in the urine presents of the protein and the RBCs. Impaired filtering capacity result in inability of kidneys to excrete excretory products like electrolytes and metabolic waste products that will then accumulate in the blood. Furthermore, inability of distal convoluted tubules to excrete sufficient quantities of potassium, sodium, magnesium (Mg), chloride (Cl), urea, creatinine (Cr), alkaline phosphatase (Alk Phos), and phosphate (PO4) results in their elevation in the blood. His laboratory values reveal an increased of sodium value of 149 meq/L, an increase of potassium value of 5.4meq/L, increased chloride value of 116 meq/L, increased blood urea nitrogen (BUN) serum of 143 mg/dL, and increased creatinine serum of 7.14 mg/dL. The other abnormal blood tests associated with a loss of kidneys’ filtration property identify in this patient are related to an increase of alkaline phosphatase value of 178 IU/L, increased magnesium value of 3.8mgdL, and increased phosphate (PO4) value of 5.9 mg/dL .
In this activity Effects of Arteriole Radius on Glomerular Filtration was recorded with valve opened and closed when blood pressure changed. When the one-way valve between the collecting duct and the urinary bladder was closed the filtrate pressure in Bowman’s capsule (was not directly measured) and the GFR pressure stayed the same and glomerular filtration decreased. Increasing the systemic blood pressure stayed the same when valve was closed and GFR was low when the valve was open.
Where the kidney stone is in an advanced stage, more complex procedures are used to treat and manage the disease.
1 in 3 Americans Adults are currently at risk for developing kidney disease. What is acute renal failure, when your kidneys functions all of a sudden stop working and your kidneys are the body’s filter which remove waste products and help balance water, salts and minerals especially electrolytes in your blood when your kidneys stop working you end up building all the products in your body that need to be filtered and eliminated. The pathophysiology of Acute Renal Failure are due to three main causes Pre-renal, Intra-renal, and Post renal. Pre-renal is a sudden drop in blood pressure or interruption of blood flow to the kidneys from illness or sever injury. Intra-renal is direct damage to the kidneys by inflammation of drugs, infection, toxins or reduced blood supply. Post-renal is a sudden obstruction of urine flow because of enlarged prostate bladder tumor, kidney stones, or injury.
This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up fluids, it becomes congested. Many conditions can cause heart failure, and they include coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart.
Sepsis is also called Septicemia and is a poisoning of the blood. This is an attack of bacteria into the bloodstream. Sepsis does not need blood poisoning to occur; it can affect multiple organs or the entire body without it happening. Sepsis is the body’s systematic inflammatory response to a bacterial infection (Jones, 2017). The infection can also have a wound or a chest infection or can be spread throughout the entire body. Sepsis’ definition is “a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs” (McClelland, 2014). Sepsis is a leading cause of hospital admissions and can lead to death in hospital patients worldwide. The death rate associated with
Dialysis is used when a person’s kidneys have lost 85-95% of their functioning ability. Over 100,000 people in the US are staying alive due to kidney dialysis. Kidney dialysis is also called renal dialysis. There are two types of kidney dialysis: peritoneal and hemodialysis. Both types of dialysis remove waste, salt and extra water, which builds up in the body. Dialysis not only cleanses impurities out of the blood, it also maintains blood pressure and makes sure to keep healthy levels of sodium, bicarbonate and potassium in the body. (Lewin, 2010)
In medicine dialysis is primarily used to provide an artificial support for the lost kidney function in people with renal failure.
This article is for people whose kidneys fail to work. This condition is called end-stage renal disease (ESRD).
Their lives revolve around receiving dialysis three days a week for three to four hours per treatment, usually at an outpatient clinic. While dialysis can prolong the end stage renal disease (ESRD) patients’ lives, the three day a week trudge to this clinic can feel like an endless cycle of discomfort and inconvenience. Fortunately, the ESRD patient has more than one option, namely, peritoneal dialysis. Traditional hemodialysis (HD) is provided to the patient at an outpatient clinic that is often referred to as a chronic unit. Patients must come to the chronic unit to be hooked up to the dialysis machine, which circulates their blood through a dialyzer, thereby removing toxins and excess fluid.
These causes will change the heart significantly. The pathophysiology of heart failure is described differently as: (1) an oedematous disorder, by means of which the deviations in renal hemodynamics and excretory ability lead to salt and water holding; (2) a hemodynamic disorder, considered by peripheral vasoconstriction and decreased cardiac output; (3) a neurohormonal disorder, mainly by stimulation of the renin-angiotensin-aldosterone system and adrenergic nervous system; (4) an inflammatory syndrome, related with amplified local and circulation pro-inflammatory cytokines; (5) a myocardial disease, started with an damage to the heart trailed by pathological ventricular transformation. In heart failure, the heart sustains either a sudden or longstanding structural injury. When damage occurs, sequences of firstly compensatory but consequently maladaptive mechanisms follow (Henry & Abraham, ).
Heart failure with low blood pressure that prevents enough blood from flowing to the kidneys
Kidney Function Introduction and definition of terms: The kidneys are the main organs in the urinary system. They filter waste products out of blood from the renal artery. These are then excreted. Useful solutes are reabsorbed into the blood. They also have a major homeostatic role in the body, and help to control the water content (osmoregulation) and pH of the blood.