Signs and Symptoms of Acute Renal Failure

Is this a sudden drop in kidney function, usually characterized by higher levels of blood urea nitrogen (BUN, BUN) and creatinine, oliguria (less than 500 ml of urine within 24 hours), the hyperkalemia, and sodium retention.

 

Acute renal failure is divided as follows

• Prerenal - results from the conditions of interruption of blood flow in the kidneys, which reduces renal perfusion (hypovolemia, shock, hemorrhage, burns, impaired cardiac output, diuretics).
• Postrenal - the obstruction of urine flow.
• Intrarenal - results of a kidney injury (ischemia, toxins, immunological processes, system and blood vessels).

 

The disease progresses through three distinct phases of clinical anuric oliguric, diuretic, and recovery is primarily distinguished by changes in urine and serum creatinine and urea. Complication of ARF include dysrhythmias, increased susceptibility to infection, electrolyte imbalance, gastrointestinal bleeding from stress ulcers, and multiorgan failure. Untreated ARF can also describe the progress of chronic renal failure, renal failure and terminal uremia, or death from related causes.

 

Rating

• Anuric-oliguric phase: urine volume below 400 ml per 24 hours, increased serum creatinine, urea, uric acid, organic acids, potassium and magnesium should be 3-5 days in infants and children 10-14 days and young adults.
• Diuretic phase: begins when the urine output exceeds 500 ml per 24 hours, ending with the BUN and creatinine are increasing, the length available.
• Recovery phase: asymptomatic; take several months to a year, some scars may remain.
• In functional kidney disease: decreased tissue turgor, dry mucous membranes, weight loss, flat neck veins, hypotension, tachycardia.
• In the post-renal disease: changes difficulty urinating in the flow of urine.
• The intrarenal disease: presentation of different, usually a swelling may have fever, rash.
• Nausea, vomiting, diarrhea, lethargy and may also occur.

 

Test Evaluation

1. Urinalysis shows proteinuria, hematuria, casts. urine chemistry distinguishes different forms of ARF (renal replacement therapy, post-renal, intrarenal).
2. Levels of creatinine and urea 2.Serum are high, blood gas (ABG) level of electrolytes in serum may be invalid.
3. Untrasonography Renal estimate the size and treat kidney exclude obstructive uropathy.

 

Pharmacological and therapeutic interventions:

• Surgical barriers may be necessary.
• Corrections surplus or deficit of base fluids.
• Correction and control of the biochemical balance.
• Restore and maintain blood pressure with IV fluids and vasopressors.
• Maintain adequate food: diet low additional amino acids and vitamins.
• Initiation of hemodialysis, peritoneal dialysis, or continuous renal replacement therapy in patients with progressive azotemia and other potentially fatal complications.

 

Interventions

• Monitor the volume of urine for 24 hours following the clinical course of the disease.
• Monitor BUN, creatinine and electrolytes.
• Level monitoring of GBS as necessary to evaluate the acid-base balance.
• Weigh the patient to provide the index of fluid balance.
• Measuring blood pressure at different times of the day in the supine, sitting and standing positions.
• Adjust fluid intake to prevent volume overload and dehydration.
• Watch arrhythmias and heart failure with hyperkalemia, electrolyte imbalance and fluid overload. Is resuscitation equipment available in case of cardiac arrest.
• Beware of urinary tract infections, urinary catheter, and remove as soon as possible.
• Use of pulmonary critical care, because the incidence of pulmonary edema, and infection is high.
• Providing wound care.
• We carbohydrate diet rich in carbohydrates, because they have more protein and energy savings to provide extra calories.
• Institute seizure precautions. Benefits padded rails and airways, and suction devices at the bedside.
• Encourage and assist the patient to turn and go because the drowsiness and lethargy may limit activity.
• Explain that the patient may experience residual renal defects for a long period after the acute illness.
• Encourage the patient to report a routine urine test, and other research.
• Recommend the resumption of activity gradually, because muscle weakness will be present from the excessive catabolism.

 

via nursingcrib

How Do We Have The Anatomy Of The Kidney

The kidneys are the primary regulators, which maintain the volume and composition of body fluids by filtering the blood and selective reabsorption or excretion of filtered solutes.

renal retroperitoneal organs (eg, located behind the peritoneum) is located at the rear of the abdomen on both sides of the spine, at the twelfth rib. Left kidney is slightly higher than in the abdomen to the right, due to the presence of pus in the liver, right kidney downward.

The kidneys take their blood supply directly from the aorta through the renal arteries, the blood returns to the vena cava by the renal veins. Urine (filtrate containing the waste and water) excreted by the kidneys and ureters down the fiber accumulates in the urine. bladder muscle (detrusor) is unable to accept urine without increasing distending pressure inside, which means that large quantities can be collected (700-1000ml) without a high pressure system of location kidney damage.

When urine is passed, the urethral sphincter at the base of the bladder detrusor relaxes contracts, and urine is canceled by the urethra.

Kidney Structure

For cutting the renal cortical region from outside, pale and dark inner region medulla.The base is divided into regions, 8.18 cone, called renal pyramids, the base of each pyramid starts at the border, cortical and ends top of the renal papilla, which is connected to form the renal pelvis, and then to form the ureter. In humans, the renal pelvis is divided into two or three bedrooms, large glasses, which in turn are divided into smaller cups. Walls calyces, pelvis and ureter are covered with smooth muscle that can contract to force urine in the bladder peristalisis.

Cortex and medulla is composed of nephrons are the functional units of the kidney, kidney, and each contains about 1.3 million of them.

On the organs is the body responsible for ultrafiltration of blood and renal reabsorption or excretion products in the filtrate next. Each organ is composed of:

The glomerulus filters. 125ml/min filtrate is formed by the kidneys as the blood is filtered through this structure, like a sieve. This filtration is not controlled.

Coils of the proximal convoluted. controlled uptake of glucose, sodium and other dissolved substances is happening in this region.

Loop of Henle. This area is responsible for the concentration and dilution of urine by using against the current multiplication mechanism, in principle, is impermeable to sodium, but it can pump, which in turn affects the osmolarity of the surrounding tissue and will affect the future movements of the water collection channel permeable to water.

Distal convoluted coil. This region is responsible, with the channel that connects the collection, to bring the water body simple math will tell you that the kidneys do not give 125 ml of urine per minute. 99% of water is usually absorbed, leaving a highly concentrated stream of urine into the collection channel, and the renal pelvis.

via le.ac.uk

Chronic glomerulonephritis, damage to capillaries in the kidney

Definition

Glomerulonephritis is a condition that involves damage to the glomeruli. The glomeruli are small structures in the kidneys filter the blood.

 

bodies of the kidney bean-shaped in the back just below the ribs. Each kidney is about the size of a fist. The kidneys filter blood, catch and substances necessary to re-enter the market and the elimination of waste in the urine. If the kidneys do not filter properly, wastes build in the blood.

 

There are two types of glomerulonephritis:

• Acute glomerulonephritis begins suddenly.
• Chronic glomerulonephritis develops gradually over several years.

 

In some cases, glomerulonephritis leads to kidney failure. Renal failure is a serious disease of the kidneys, which must be treated with dialysis or kidney transplantation.

 

Causes
Causes of glomerulonephritis include:

• Streptococcal pharyngitis (strep throat) or skin (impetigo).
• Hereditary diseases
• Immune diseases like lupus
• Diabetes type 1 and type 2 diabetes
• Hypertension
• Vasculitis (inflammation of blood vessels)
• Viruses (HIV, hepatitis B and C)
• Endocarditis (infection of heart valves)

 

Risk Factors

A risk factor is something that increases the chances of the disease or condition. Risk factors for glomerulonephritis include:

• Family history of glomerulonephritis
• The presence of a known cause of nephritis

 

Symptoms

Glomerulonephritis often causes no symptoms, and detected during a routine urine test. Where appropriate, signs of acute glomerulonephritis and chronic are different. The symptoms of acute glomerulonephritis may include:

• Blood in the urine (red, brown or tea-colored urine)
• Foamy appearance of urine
• Less frequent urination
• Swelling in the morning, especially in the face, feet, hands and stomach

 

Chronic glomerulonephritis can lead to kidney failure, which can cause these symptoms:

• Fatigue
• Dry skin, itching
• Nausea
• Vomiting
• Lack of appetite
• Muscle cramps in the night
• Swelling of the face, feet, hands or abdomen

 

Diagnosis

Your doctor will ask about your symptoms and medical history and perform a physical examination. You may be referred to a doctor who specializes in kidney disease for diagnosis and treatment (nephrologist).

 

Tests may include:

• Urine tests to look for blood, protein, bacteria and other evidence of kidney damage in urine
• Blood tests, tests to verify the proper functioning of the kidneys and to look for the disease, which can cause glomerulonephritis
• Ultrasound, a test that uses sound waves to create images of the kidney
• A CT scan of the abdominal cavity, a type of x-ray test that uses a computer to create detailed images of structures inside the abdomen, including kidneys
• Renal biopsy, needle sample of kidney tissue to test for glomerulonephritis

 

Treatment

Treatment depends on the cause of glomerulonephritis. For example, control of blood pressure and levels of blood sugar with drugs will be important in the treatment of glomerulonephritis associated with hypertension and diabetes. In addition, the following measures can be taken for assistance or further reduce kidney damage:

Drugs

• Diuretics to reduce fluid retention
• Drugs that inhibit the immune system

 

Changes in lifestyle

• Limit your intake of salt and water.
• Reduce consumption of potassium, phosphorus and magnesium.
• Reduce the amount of protein in the diet.
• Maintain a healthy weight through diet and exercise.
• Take calcium supplements.

 

Dialysis and Transplantation

If the kidneys are not able to remove enough waste in the blood, dialysis may be necessary. Temporary dialysis may be sufficient for acute glomerulonephritis. If it leads to permanent kidney failure, chronic glomerulonephritis requires a long-term dialysis or a kidney transplant.

 

Prevention
The following steps can reduce the risk of inflammation of the kidneys:

• Consult a doctor immediately if you have a sore throat, which can be caused by STREP.
• To reduce the risk of viral infections, including HIV, safe sex and avoiding intravenous drug.
• If you have diabetes or hypertension, your doctor about managing these conditions.

 

via aurorahealthcare