Acute Renal Failure :
Acute Renal Failure Pathophysiology- renal failure develops over days or weeks
Manifests itself in an increase in serum creatinine and blood urea nitrogen (BUN)
Type are classified due to causes (area of kidney where problem occurs)
Causes of Acute Renal Failure :
Causes of Acute Renal Failure Hypovolemia
Hypotension
Reduced cardiac output and heart failure
Obstruction of the kidney or lower urinary tract
Obstruction of renal arteries or veins
Types of acute renal failure include: :
Types of acute renal failure include: Prerenal- common with intravascular volume depletion: Fever, vomiting, and diarrhea, diuretics, dehydration can lead to decreased kidney perfusion.
Intrarenal - tubular, glomerular, interstitial, and vascular injury. NSAIDS and contrast dye can tubular injury.
Postrenal- obstruction of the outflow tracts of the kidneys. Causes include prostatic hypertrophy, catheters, tumors, strictures, and crystals.
Types of ARF :
Types of ARF
Phases of Acute Renal Failure :
Phases of Acute Renal Failure Phases of rapid decrease in renal function lead to the collection of metabolic wastes in the body.
Phases include:
Onset – UOP >400ml/day
Oliguric – UOP<400ml/day last few days-2weeks
Diuretic- urinary output increase
Recovery – returning to baseline renal function may take weeks-months (up to a year) lab values return to normal
Acute syndrome may be reversible with prompt intervention.
Assessment :
Assessment History
Clinical manifestations
Laboratory assessment- ↑ bun &creatitine, metabolic acidosis, hyponatremia, hyperkalemia, hypocalcemia,
Radiographic assessment- kidney size, stones, renal stenosis
Other diagnostic assessments such as renal biopsy
Treatment :
Treatment Diet therapy
Treat underlying cause
Treat any complications
Dialysis therapies
Hemodialysis
Continous Renal Replacement Therapies (CRRT)