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
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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
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 .
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.
Glomerulonephritis is a disease that causes the inflammation of kidneys’ filters. The kidneys’ filters are in charge of remove the waste from the blood, and then excreted it as urine. Even though Glomerulonephritis can be caused by itself, diabetes and lupus can ...
Some may think that they words acute kidney injury and chronic kidney disease mean the same thing, but that is incorrect. Kidney failure results from the kidneys not being able to eliminate metabolic waste products and water, which can also disturb all other organs of the body. Acute kidney injury (AKI) is a sudden and rapid loss of kidney function that usually occurs over hours to days due to acute tubular necrosis. Acute tubular necrosis is a process where ischemia affects parts of the kidneys and disrupts the basement membrane and the tubular epithelium. Chronic kidney disease (CKD) has a gradual onset and can take place over many years. CKD is seen in many diabetic patients due to diabetic neuropathy. AKI is a much more serious issue and should be taken very seriously.
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.
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
According to the Mayo Clinic, Kidney Failure occurs when the kidneys are suddenly unable to filter waste products from the blood. This occurring, results in the body beginning to accumulate high levels of dangerous waste, which eventually leads to a chemical imbalance in the blood. Symptoms of the kidney’s inability to
Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.
If the patient has a urinary catheter, and most ICU patients do, he or she may not have any reportable symptoms. Therefore, good assessment of urinary elimination, done in relation to a patient’s signs, symptoms, urine amount, intake and output, and lab values, is important. The lab values are discussed in Chapter 5. Acute and chronic renal failure can cause numerous systemic symptoms and altered homeostasis ( Collins, 2011). See Table 3-10 for abnormal urinary elimination.
Acute kidney failure occurs when your kidneys become inadequate to filter waste products that form in your blood. Chemicals start to build up in your blood that could be fatal. If you catch it soon enough you can reverse the effect and come back to regular kidney functions.
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
If damage to the kidney continues, eventually the nephrons well die and total kidney failure will result. The acute form develops suddenly. The condition may develop after an infection in the throat or skin and symptoms commonly include facial puffiness, urine retention and bloody urine. Shortness of breath may also occur as a build up of fluid occurs around the lungs. Ordinarily acute glomerulonephritis will cease on its own, though dialysis is sometimes required for those afflicted who have a large amount of extra fluid within the body. Two further conditions are associated with this disease and those are nephritic syndrome and nephrotic syndrome. Nephrotic syndrome is characterised by the presence of proteinuria within the urine and this release of protein from the body can adversely affect osmotic processes in the body, leading towards irregular dehydration of the cells and pooling of fluids elsewhere in the body in the form of oedema, mainly noticeable within the face and
Acute renal failure is the inability of your kidneys to function properly. When acute renal failure occurs the kidneys lose the ability to remove waste and the ability to balance fluids and electrolytes.
Nephrotic syndrome occurs when the kidneys' filters (glomeruli) are damaged. Glomeruli remove toxins and waste products from the bloodstream. As a result of damaged glomeruli, essential products such as proteins may also be removed from the bloodstream. The loss of proteins and other substances the body needs causes nephrotic syndrome. Nephrotic syndrome may increase your