Acute Renal Failure

According to Levin (2002). Acute renal failure is the generic term for an abrupt and sustained decrease in renal function resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products.

The causes of Acute renal failure can be broadly divided into three categories, prerenal, intrarenal, postrenal. In Prerenal form there is a reversible increase in serum creatinine and blood urea concentrations, it results from decreased renal perfusion also known as renal hypoperfusion, which leads to a reduction in glomerular filtration rate (GFR). According to Kathleen D. and Gleen C. (2010). Prerenal satge can complicate any disease that induces hypovolemia result from renal fluid loss like taking diuretics and decreased water intake. Low cardiac output state, systemic vasodilation or selective intrarenal vasoconstriction. In intrinsic stage also known as intrarenal stage what happened according to Glenn C. and Kathleen D. (2010). It can conceptually divided on the predominant compartment of the kidney that is affected like the disease of larger renal vessels due to vasculitis, disease of the renal microcirculation and glomeruli due to postinfection, glomerulonephritis, disease caused by antibody to glomerular basement membrane, the tubulointerstitial diseases that is associated with drugs and the ischemic or nephrotoxic tubular injury due to exogenous factor like antibiotics and radio contrast agents, and due to endogenous factor like the intratubular pigments (heamoglobinuria, myoglobinuria), intratubular proteins (myeloma), intratubular crystals (uric acid oxalate). In postrenal stage according Kathleen D. and Gleen C. (2010) that it is from the obstruction to urine flow in the external urethral meatus and th...

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...chemical control, shorter stay in intensive care unit. Disadvantage greater vascular access problems, higher risk of systemic bleeding , long-term immobilization of patient, more filter problems(ruptures, clotting), greater cost.

Nursing Goals

Nursing short term goals for acute renal failure is monitoring of azotemia, electrolytes, acid-base status, lung sounds/respiratory rate for volume overload, urine output and blood pressure. Azotemia may continue to increase initially depending on cause, then may slowly improve over the course of days to weeks.

Long term goals is In some cases, complete recovery from renal insult may occur, whereas in others, some residual renal damage remains. For those who remain azotemic, monitoring should be as for long-term CFR patients. For patients with complete recovery, periodic monitoring of BUN and creatinine is still recommended.