Calixtro, Laidelle Jascinth M.

BSN-III

NARRATIVE PATHOPHYSIOLOGY OF ACUTE RENAL FAILURE

Acute renal failure is traditionally defined as a rapid fall in the rate of glomerular
filtration, which manifests clinically as an abrupt and sustained increase in the serum
levels of urea and creatinine with an associated disruption of salt and water
homeostasis (Hilton, 2011). This removal is the central feature of the kidneys. Body
fluids can escalate to harmful levels as kidneys lose their capacity to filter. The disease
will also allow electrolytes and waste material to collect in the body, which can also be
life-threatening. The major categories of ARF are prerenal (hypoperfusion of kidney),
intrarenal (actual damage to kidney tissue), and postrenal (obstruction to urine flow).
Prerenal ARF, which occurs in 60% to 70% of cases, is the result of impaired blood
flow that leads to hypoperfusion of the kidney and a decrease in the GFR. This is
caused by hypotension, decreased cardiac output and decreased effective arterial
blood volume. Intrarenal ARF is the result of actual parenchymal damage to the
glomeruli or kidney tubules. Acute tubular necrosis (ATN) is the most common type of
intrinsic ARF. Characteristics of ATN are intratubular obstruction, tubular back leak
(abnormal reabsorption of filtrate and decreased urine flow through the tubule),
vasoconstriction, and changes in glomerular permeability. These processes result in
a decrease of GFR, progressive azotemia, and fluid and electrolyte imbalances. CKD,
diabetes, heart failure, hypertension, and cirrhosis can lead to ATN. Postrenal ARF
usually results from obstruction distal to the kidney. Pressure rises in the kidney
tubules and eventually, the GFR decreases (Hinkle & Cheever, 2018).

Acute kidney failure can be a life-threatening illness. Chronic renal failure or

end-stage renal disease can develop. There’s a greater risk of death if kidney failure
is caused by severe infection, trauma, or surgery. With proper treatment and diligence,
your chances of recovery are good. Seek immediate and regular medical care for
acute kidney failure, and ask your doctor questions about what you can do to heal
faster (Normadin & Yu).

REFERENCES:

Hinkle, J. L., Brunner, L. S., Suddarth, D. S., & Cheever, K. L. (2018). Brunner &
Suddarth's textbook of medical-surgical nursing. Philadelphia: Wolter Kluwer

Hilton R. (2011). Defining acute renal failure. CMAJ : Canadian Medical Association
journal = journal de l'Association medicale canadienne, 183(10), 1167–1169.
https://doi.org/10.1503/cmaj.081170

Normandin, B., & Yu, W. (n.d.). Acute kidney failure: Causes, risk factors, and
symptoms. Healthline. https://www.healthline.com/health/acute-kidney-failure