Renal Failure Renal Failure Causes and Management

Definition of Terms

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Renal Failure- abnormal kidney function in which the kidneys are unable to adequately excrete toxic substances from the body. Acute (sudden) kidney failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing electrolytes Chronic renal failure (ESRD) is the progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic and fluid and electrolyte balance fails. Septic shock-shock caused by bacteria. Severe systemic infection Acute Tubular Necrosis-acute damage to the renal tubules usually due to ischemia associated with shock.

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Acute Nephrotic Syndrome-condition that seriously damages the glomerular capillary membrane and results in increased glomerular permeability to plasma protein Septicemia-presence of pathogenic bacteria in the blood. Dialysis-process of diffusing blood across a semipermeable membrane to remove toxic materials and to maintain fluid, electrolytes and acid base balance. Glomerulonephritis-inflammation of the glomerular capillaries Scleroderma-sclerosis of the skin and certain organs like GIT, lungs, heart and kidneys Hemolytic Uremic Syndrome-An acute condition consisting of microangiopathic hemolytic anemia, thrombocytopenia and acute nephropathy

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Placenta abruption-premature separation of placenta Placenta previa-low lying placenta/implanted in the lower uterine segment Hyperkalemia-excessive amount of potassium in the blood Diabetes Mellitus-disorder of carbohydrates metabolism, characterized by hyperglycemia and glycosuria and resulting from inadequate production or utilization of insulin

Causes of Renal Failure

There are many possible causes of Acute Kidney Failure. They include:  Decreased blood flow, which may occur with extremely low blood pressure caused by trauma, surgery, serious illnesses, septic shock, hemorrhage, burns, or dehydration  Acute tubular necrosis (ATN)  Infections that directly injury the kidney such as acute pyelonephritis or septicemia  Urinary tract obstruction (obstructive uropathy)  Autoimmune kidney disease such as interstitial nephritis or acute nephritic syndrome

Disorders that cause clotting within the thin blood vessels of the kidney  Transfusion reaction  Malignant hypertension  Scleroderma,  Hemolytic-uremic syndrome  Disorders of childbirth, such as bleeding placenta abruptio or placenta previa

Causes of Chronic Renal failure    High blood pressure  Urinary Tract Obstruction  Glomerulonephritis  Diabetes Mellitus  Kidney abnormalities such as polycystic kidney disease.

Treatment and Management

Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal. Usually, you have to stay overnight in the hospital for treatment. The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the build-up of toxins normally handled by the kidneys. This diet may be high in carbohydrates and low in protein, salt, and potassium. You may need antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help the kidneys lose fluid.

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It will be very important to avoid dangerous hyperkalemia (increased blood potassium levels) by using IV (intravenous) calcium, glucose/insulin, or potassium exchange resin (Kayexalate). Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your serum potassium is dangerously high. Dialysis will also be used if your mental status changes, your potassium level starts to rise, you stop urinating, develop pericarditis, become overloaded with fluid, or cannot eliminate nitrogen waste products from your body.

The need for dialysis may be acute or chronic Acute Dialysis is indicated when there is a high and increasing level of serum potassium, fluid over load, severe confusion, pericarditis. It may also be used to remove certain medications or other toxins from the blood. Chronic Dialysis or maintenance dialysis is for ESRD.

Types of Dialysis Hemodialysis – most common method. It is used for patients who are acutely ill and require short term dialysis and for pts with ESRD who require long term or permanent theraphy. For patients with CRF, this method prevents death, although it does not cure renal disease and doe not compensate for the loss of endocrine and metabolic

Peritoneal Dialysis- may be the treatment of choice for patients with renal failure who are unable or unwilling to undergo hemodialysis or renal transplantation.

Thank You and Good Day

Presentor Charina L. Pou IV-Modesty

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