Acute renal failure

Acute renal failure's disease overview

Kidney is an organ in the urinary system, in charge of many important functions:

  • The main function of the kidney is dialysis and waste. In the process of producing urine, the kidneys will excrete waste such as uric acid, urea and ammonia ... and only retain protein, blood cells.
  • The function of controlling and regulating blood volume: the kidneys play an important role in controlling the amount of extracellular fluid in the body by producing urine. When we drink plenty of water, the amount of urine will increase and vice versa.
    • kidney helps maintain the pH of extracellular fluid, regulates the concentration of ions in the blood.
  • The producing multiple hormones necessary for the body such as renin, calcitriol and erythropoietin.

    • The kidneys work 24 hours a day to remove excess water and waste in the body. Healthy kidneys can filter 300 times the amount of blood in the body every day

    What is

    What is acute kidney failure?

    acute renal failure is a syndrome caused by many causes, which may be the cause of the kidneys or the kidneys, collapse or lose temporary function, acute of both kidneys , due to rapid stopping or decline in glomerular filtration level.

    Clinical manifestations are an urinary or acute anuria, followed by an increase in nitrogen nitrogen in the blood, water and electrolyte balance disorders, alkali -–toan balancing disorders, edema and hypertension. acute renal failure has a high mortality rate, but if diagnosed and treated promptly, the kidney function can recover completely or completely.

    Causes of Acute renal failure's disease

    acute renal failure is divided into 3 groups of causes:

  • Causes of renal acute renal failure

    • Acute renal impairment is a common cause, accounting for 50-60% of the causes of acute renal failure. Including:

  • Reduce the volume of circulation due to:
    • bleeding.
  • Digestive discharge: vomiting, diarrhea ...
  • Loss of fluid through kidneys: diuretics, diabetes (osmotic diuretics), diabetes, adrenal impairment ...
  • Dehydration through the third cavity: Burns, Pancreatitis, Peritonitis, Heavy Albumin Lose ...
  • Loss of skin: Burn, sweat, increase body temperature
  • Reduced amount of imported amounts: Eat little, psychotropic.
  • Systemic vasodilation in shock (anaphylaxis, infection shock). 

    • Large blood vessel disease includes aortic clamp during surgery, aortic aneurysm, blockage, obstruction or narrowing of the kidney.

    Causes of kidney failure in the kidneys.

  • primary glomerular disease, the cause of acute renal failure may be a complication of acute glomerulonephritis after streptococcal infection.

    • Secondary glomerular disease: Lupus glomerulonephritis during acute progress. Goodpasture syndrome ...

    Causes of acute interstitial kidney inflammation: wrong transmission of ABO blood type, poisoning, chemicals ...

    Kidney trauma.

    Atherosclerosis, thrombosis ...

  • Causes of renal impairment.

    • Causes of urinary tract obstruction:

  • Pyelonephritis, ureteral stones.
  • Tumor compression: bladder tumor, ureter tumor
  • Causes of fibrosis, urinary tract narrowing

    • Symptoms of Acute renal failure's disease

    Signs acute renal failure progress through 4 stages:

  • Starting phase:

    • This is the attack stage of pathogens. Short long developments depending on the cause.

  • Less, urinary tract:

    • Animal can slowly develop, the patient may urinate less and then dawn, but the cause of anuria, can occur suddenly, especially in the case of poisoning or due to mechanical causes.

  • Urine <500ml/24 hours (Distant), <100ml/24 hours (east).

    • Water disorders, electrolytes and alkaline balance, edema depending on the level, dependence on the amount of water introduced, can be edemated, multi -membrane overflow.

  • Hypertension, pericardium causing acute heart pressure, hyperkalemia causing arrhythmia and cardiac arrhyths.

    • Hemorrhage syndrome such as: Difficulty breathing, nausea, coma, convulsions, hemorrhage.

  • The return stage:

    • The amount of urine increases rapidly in a case of 4-5 liters/day or more, lasting 5-7 days. Urea, blood creatinine gradually decreases, urea and creatinine urine increases, renal failure turns to recovery stage.

  • Recovery phase:
  • The volume of urine gradually returns to normal.

    • Biochemical disorders gradually return to normal.

    However, the ability to concentrate the urine of the renal tubules takes a lot of time when it comes every year to recover completely, the level of glomerular filtration recovers faster. Usually the second month can be normal, the recovery is fast, slow depending on each cause, the average treatment regime is about 4 weeks.

    People at risk for Acute renal failure's disease

    Anyone may suffer from acute renal impairment, but some subjects are at high risk, including:

  • Older people
  • Hypertension;

    • Diabetes

    Cardiovascular disease

  • Pathology in the liver, kidneys
  • Vascular disease

    • Prevention of Acute renal failure's disease

  • Diet with low protein to prevent the complications of the disease.
  • Limit foods such as chocolate, some fruits or many potassiums from the daily diet. The doctor's indications.
  • Monitor the weight and water you drink as well as the amount of urine out daily.
  • report to doctors if you are contaminated with toxic chemicals/other drugs. People are using, including non -prescribed drugs.

    • Diagnostic measures for Acute renal failure's disease

    Clinical symptoms:

  • Sudden decrease in glomerular filtration level: The volume of urine <0.5ml/kg/hour for 6 hours.
    • Clinical body: Based on the volume of urine.
  • Digestive cuses: Urine <400ml/day (<200ml/12 hours)
  • Calmia: Urine <200ml/day (<100ml/12 hours)
  • Conservation of urine: The amount of urine is over 400ml/day. The prognosis is better than the above.

    • Subclinical symptoms:

  • Definite diagnostic test: URE, blood creatinine

    • Other tests: To evaluate complications and weight, find the cause.

  • Hematology: Find anemia, infection ...
    • biochemical: potassium, creatinine, plasma urea increased, arterial blood gases have metabolic acidosis (pH decreased <7.30, HCO3 decreased), blood calcium, CPK, myoglobulin. urine: Protein, electrolytes, urea, creatininuria, urinary osmosis, cell penetration pressure, pillars immune: antibodies antibodies, antibodies against glomerular peremia, panca.
  • Imaging diagnostic: Find the cause.
  • Urinary and non -prepared urinary system, urinary ultrasound: stones, acute renal pelvis, ...
  • CT scan abdominal cavity, nuclear radioactive scan, renal angiography magnetic resonance.

    • Acute renal failure's disease treatments

    General principles in the treatment of acute renal failure

  • Quickly eliminate the causes of acute renal failure if any (depending on the group of causes that have appropriate treatment).
  • Adjust circulating disorders, the most important of which is to restore blood and fluid, maintain systolic blood pressure 100 - 120mmHg.
  • Recover the urine line
  • Adjust the home lip disorders caused by acute renal failure
  • Symptomatic treatment suitable for each stage of the disease.
  • Defining dialysis outside the kidneys when necessary.
  • Pay attention to the diet, balance the electrolyte water suitable for each stage of the disease.

    • Specific treatment:

  • Treatment of acute renal impairment:

    • Blood loss: hemostasis, red blood cell transmission, compensation for the volume of the circulating by 0.9%NaCl, high molecular fluid

    Loss of epidemics: Isometric salt, high molecular, albumin depending on blood pressure, HB test, plasma albumin.

    Anti -shock, maintenance of blood pressure

  • Treatment of acute renal failure

    • Use careful diuretics, when there is enough water and in the diuretic discharge

    Avoid kidney poisoning and adjust the dose of drugs excreted through the kidneys depending on the degree of glomerular filtration (non-steroid anti-inflammatory, aminoglycoside, contrast drugs ...)

  • Treatment of acute renal failure: eliminating the cause of obstruction
  • Support treatment, complications
  • Water balance control and hemodynamic guarantee
  • Control of alkaline balance, electrolytes
  • A low -protein diet
  • Antibiotic antibiotics: avoid antibiotics to the kidneys, adjust the dose according to creatinine clearance.

    • Artificial kidney treatment:

  • Emergency dialysis appointment:
  • If hyperkalemia does not respond to medical treatments (K+ blood> 6.5 mmol/l).
  • When there is a signal of metabolic blood acidosis <7.2
  • Excess juice causes acute pulmonary edema or acute pulmonary edema
  • Dialysis methods:
  • Level of peritoneal authority
  • Intermediate dialysis
  • Continuous dialysis

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