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:26 /" .

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:

BUN/

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:

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- 400-500" ) . (400
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:
80% ARF- ATN-.

90% intrinsic renal- ) ATN -

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3
:

-Effective volume depletion

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effective- :
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Hypercalcemia, Hepato-Renal syndrome, cyclosporine A:
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:
Myogenic stretch receptors

Angiotensin II

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FENa= UrineNa * volume / plasmaNa * GFR X 100= U/P [Na]/U/P [Cr] X 100
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1%- acute tubular necrosis -

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.
:
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Plasma BUN/Creatinine > 20
.
: , - .

hyaline casts- TAL Tamm horsphal


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) (.
:

.1
.2
.3
.4
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) (:
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Acute interstitial nephritis
Acute GN
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.

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50- .10-20
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PT- : MD-
MD- GFR- TGF-
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. GFR-.
:


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.
:
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. Tamm horsphal-
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GFR
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, ATN-:

:
) initiation-( - " .
. .reperfusion injury
-Maintenance .
. .
.

:
Differentiation

Proliferation

Migration

:
pre-renal-
- ) (ATN
) 20" ( . ) isosteuria
( , ) 10--
FE .)15 ) 1%- ( . , tamm
.horsphal .
pre-renal ATN-:
ATN

Pre-renal

<1%

>1%

FE Na

<20

>10

UNa

~USG 1.020< 1.01


~300

<500

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U osmol
BUN/Creat

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pre-renal .ATN-
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ATN .
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ATN " :

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(.
, , -

.
- .

-FE Na <1% ) " (.

) (stick , .

) - (.

" .radio immunoassay

:
volume depletion . "
) ,tamm horsphal-
( . 300" ) (.
. ) fasioctomy
( .
" ) ( .
.
scavenger . ATN-
. ATN )
( . )(
. ATN .
ATN " :

) ( . , ,
) G6BD ( . .
ATN- ) tumor lysis syndrome

(-
) ( " )
( DT- )
.(acute uric acid nephropathy .Ca/P
.
:

) (
Uric Acid, P, K : ) (.
) (.
-Uua/Ucreat> 1 mg/mg .

- ) (:
-Allopurinol ."

).(urate oxidase

. .
ATN :

.ATN PT-
.
PT- . PT-
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) ATN( . ) (.
Multiple myeloma Cast nephtopathy ATN- .
:
Interstitial nephritis

TLS- .

ATN :
)
( . "
GFR- .
. .
: , , ,.
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ATN . 24-48 ATN 3-5


5-7 . .
:
- GFR TGF
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:
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.2


.3
ATN
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EF- .1%-
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.
N acetyl cysteine " .SH
. .
ATN .
:

Volume depletion


) ( , ,
' .
.
)(NSAID
-
- .
ATN ) (:

PT-
. PT- .
) ( .
3 3 .
.
7-10 .
)( ." . .
.
, .
: .
:

- ) ( .NSAID

(.

ATN :NSAID -

.
) ( PG .GFR-
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:
AA GFR- . .ATN-
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NSAID ) (
) ,MCD - (.

.ACE
:
:
.
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) ( . .
.
.
ARF- 20% .50%
:
, )
.1
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)(
.2
.
.3
:ATN-
:

ATN :

-
.1
-
.2

-
.3

.4
- ,
.5
)( , , ' .
) (
.
.

.80%

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