Renal Failure is a common condition that could also be described as Acute renal failure (ARF) or Chronic renal failure(CRF), both conditions occur when there is a loss of kidney function. Kidney disease or renal failure is the ninth leading cause of death in the United States (Pradeep ,2014). Specifically, acute renal failure is characterized by the kidney’s sudden inability to filter blood, excrete wastes, concentrate urine, preserve electrolytes, and sustain fluid balance which leads to many problems in the human body. Acute renal failure alone is a frequent clinical problem, especially in the intensive care unit, where according to Clin (2004), “is associated with mortality of between 50% and 80%” (p5). As for the pathophysiology part of acute renal failure inadequate blood supply to an organ, ischemia plays a large role. If a person has ischemia for more than 2 hours it can result in irreversible damage to the kidneys. Significant reduction in glomular filtration rate (GFR) is a result of ischemia, activation of the renin-angiotensin system, and tubular obstruction by cellular debris. As nephrotoxins damage the tubular cells and the same cells are lost through necrosis, the tubules become more permeable which results in filtrate absorption and a reduction in the nephrons ability to eliminate waste.
There are three causes of renal failure which include prerenal, intrarenal, and postrenal. Prerenal disorders are before the nephron and are used to refer to any disruption on the cardiovascular side of the nephron. Anything that originates in the circulatory blood supply of the nephron that impairs its function is classified as prerenal. In Intrarenal disorders the problem arises from within the nephron tubules themselves, ...
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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 .
According to the Mayo Clinic Staff (2012), acute kidney renal failure occurs abruptly when your kidneys lose their filtering abilities and cannot filter waste products from your blood. This is also known as acute renal failure or acute kidney injury. When this happens, high levels of waste may become accumulated in your blood and will alter your bloods chemical make up causing them to get out of balance. This failure or injury could happen rapidly over a few hours or a few days and can become fatal. Mostly people who are hospitalized and who are critically ill will need intensive care. If you take care of your body, acute kidney may be reversible and you may recover normal kidney function.
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.
Pathophysiology There are three different stages of acute renal failure; prerenal, intrarenal, and post renal. Prerenal failure is a result from an illness or injury that causes obstruction of blood flow to the kidneys, called hypoperfusion. Hypotension, hypervolemia and inadequate cardiac output are all examples that could cause prerenal failure. According to Lippincott Williams and Wilkins (2009), “prerenal azotemia, excess nitrogenous waste products in the blood, account for 40% to 80% of all cases of acute renal failure” (p. 307). Intrarenal is when there is direct damage to the kidney tissue by either inflammations, drugs, infections or a reduction in the blood supply to the kidney. Post renal is when there is an obstruction of the urine flow. Causes of obstruction could be enlarged prostate gland, kidney stones, bladder tumor or injury. There are four phases of acute renal failure; onset, oliguria, diuresis and recovery. The onset phase can last hours or up to days. The BUN and creatinine levels may start to increas...
Overall, for an acute kidney failure patient the hope is that they are able to have complete recovery and be free of complications and electrolyte and fluid imbalances by the end of treatment. Though, this is not true for most, because many AKI patients have co-existing morbidities and need treatment until the end of life. As nurses all we can do is give the best care that we know how and make our patients feel as comfortable as possible while they’re under our care.
Acute renal failure is a steady and fast deterioration of the functioning of the kidneys. This happens when there is a high level of the waste from the kidneys is left unattended. Acute renal failure occurs when the kidney fails to push out the waste or the everyday toxins out of the body in the form of urine. Simply put the kidneys have stopped working, they have lost their ability to filter water and waste from the blood. The kidneys remove the waste products help balance salt, water, and other minerals in our blood. With acute renal failure the kidneys lose the ability to remove waste and concentrate urine without losing electrolytes.
Currently there are two types of renal replacement therapy. The original dialysis which we called it hemodialysis used for patients with chronic renal failure, needs the patients to come to hospital 2-3 times per week. This type of dialysis called the intermittent hemodialysis .However the intermittent hemodialysis is difficult to do it in the intensive care population with acute renal failure because of the hemodynamic instability and those type of patients usually are the most sick and critically ill patients within the intensive care units and have multiorgan dysfunctions, so medically is too difficult to do for them intermittent hemodialysis. In addition intermittent hemodialysis will increase the mortality and morbidity among them. Within the modern intensive care units new way of dialysis has been developed 30 years ago called continuous renal replacement therapy (CRRT).The definition of (CRRT) is any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of time and applied for or aimed at being applied for 24 hours/day, Bellomo R., Ronco., Mehata R. The CRRT was found because the traditional way of ...
As a result of this there is insufficient blood flow to the kidneys. Secondly, Acute intrinsic kidney failure occurs when there is direct trauma to the kidneys. This usually occurs when taking a sever hit to the body near the kidneys. Other factors could be toxin overload and ischemia, lack of oxygen to the kidneys caused by renal blood vessel obstruction, shock, sever bleeding or inflammation. Chronic pre-renal kidney failure is a third type of kidney failure occurring when there is a long-term lack of blood flow to the kidneys. This type of kidney failure usually causes the kidneys to shrink and lose their function. Then, Chronic intrinsic kidney failure occurs by direct trauma to the kidneys due to severe bleeding or lack of oxygen. Lastly chronic post-renal kidney failure is a result of blockage of the urinary tract prevention urination and causing pressure eventually leading to kidney
Kidney damage can occur from hypertension which causes blood vessels in the kidneys to shrink and harden; infections travelling though the bloodstream; long-term and uncontrolled diabetes, and genetically inherited kidney problems. (Edith Cowan University, 2001-2004)
Complications related to diabetes and nephropathy are said to account for 50% of new cases of end stage renal disease (...
This article is for people whose kidneys fail to work. This condition is called end-stage renal disease (ESRD).
Customer reported that he has been diagnosed with a stage 4 renal failure. Customer is receiving medical care and has been recommended to have a kidney transplant. Customer reported that he has found a person that wants to help him, but does not have the economic support.
Acute Renal Failure is an abrupt or rapid decline in Renal filtration function. Acute tubular necrosis is one of the most common causes of acute kidney failure and it has a high mortality rate of around 50 percentage. It causes damage to the tubular portion of the nephron. An etiology of acute tubular necrosis Cn be varied, the common factor is that there is a reduction of oxygen and nutrients to be active to tubular cells, which result in ina lack of cell function and patchy necrosis. The tubular cells will regenerate at the basement membrane level. The aim is to keep the patient alive and well during this regeneration phase and almost full recovery can be made provided the appropriate and timely treatment is undertaken. When the kidney sustains
Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of hypovolaemic shock, as some of the signs and symptoms could have been attributed to her kidney failure (Macintosh and Moore, 2011; Murphy and Byrne, 2009).
The kidneys are a bean-shaped organ in the human body and they have different functions and are of vital importance for it. The kidneys are the pair of organs, which are able to regulate the reabsorption of ions such as potassium, sodium and calcium, which are fundamental substances for the cell. Furthermore, they are involved in the reabsorption of nutrients in the bloodstream and they can regulate the acidity of the blood. Besides the regulation of the fluids and ions, the kidneys are also responsible for the regulation of many different hormones that are involved in homeostasis and metabolism. Because of their importance in the regulation of substances in the body, when the kidneys stop working properly all the body is influenced by that creating disequilibrium in the maintenance of homeostasi...