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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Chronic kidney disease also denoted as chronic renal failure is the gradual failure of the kidney to perform its function as required. The condition occurs gradually thus goes undetected until when it is too late. According to Buttaro et al (2013, p.723), there are certain risk factors that lead to the development of chronic kidney disease that individuals should be conversant with. Chronic kidney disease is hereditary meaning it can be passed from a parent to a child via genes. Age is another factor. This implies that people over 60 years are likely to get the disease thus should be cautious. Individuals having atherosclerosis, bladder obstruction, chronic glomerulonephritis or congenital kidney disease are also at the risk of getting the
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
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.
In 1954, the first organ transplant was conducted successfully in the United States. (Clemmons, 2009) Nowadays, the technology of organ transplant has greatly advanced and operations are carried out every day around the world. According to current system, organ sales are strictly prohibited in the United States. (Clemmons, 2009) However, the donor waiting list in the United States has doubled in the last decade and the average waiting time for a kidney is also increasing. (Clemmons, 2009) In the year 2007, over 70,000 patients were on the waiting list for a kidney and nearly 4500 of them died during the waiting period. In contrast to the increasing demand for kidney, organ donation has been in a decrease. (Wolfe, Merion, Roys, & Port, 2009) Even the government puts in great effot to increase donation incentives, the gap between supply and demand of organs still widens. In addition, the technology of therapeutic cloning is still not mature and many obstacles are met by scientists. (Clemmons, 2009) Hence, it is clear that a government regulated kidney market with clear legislation and quality control is the best solution to solve the kidney shortage problem since it improves the lives of both vendors and patients.
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...
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)
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
United States Renal Data System (USRDS). (2008). Annual data report: Incidence and prevalence. Retrieved July 8, 2009, from http://www.usrds.org/2008/pdf/V2-02-2008.pdf
This article is for people whose kidneys fail to work. This condition is called end-stage renal disease (ESRD).
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, ).
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.
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.
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...