Definition of "Renal failure"

Last modified: 1 day



Renal failure is where the kidneys fail to adequately filter waste products from the blood.

Classification
  • Acute kidney injury (AKI), which is abrupt loss of kidney function developing within 7 days. It is often reversible with adequate Tx
  • Chronic kidney disease (CKD), which is often not reversible
Sx

For acute kidney injury:

  • Metabolic acidosis
  • Hyperkalemia
  • Uremia
  • Changes in body fluid balance
  • Effects to other organ systems

For chronic kidney disease:

  • Increased fluid in body (leading to swelling)
  • Acidosis
  • Hypocalcemia
  • Hyperphosphatemia
  • Hyperkalemia
  • Anemia, in later stages

Patient information

So chronic kidney disease causes various electrolyte imbalances. Why does what change?
The kidney excretes urine, so there'll be increased fluid in the body. The kidney creates bicarbonate, so there'll be acidosis. The kidney makes calcitriol, the active form of vitamin D, which helps to increase blood calcium, so there'll be low calcium. Because calcium will be resorbed from bone, there'll be an increase in calcium phosphate, and therefore, also phosphate. The kidneys are also involved with excreting potassium, so if there's problems with it, it can't get rid of it. In fact, even with the phosphate, it's very similar, the kidneys can't excrete it.

Causes

For acute kidney injury:

  • Decreased renal blood flow (renal ischemia) due to e.g. low blood pressure
  • Exposure to substances harmful to the kidney
  • Inflammatory process in the kidney
  • Obstruction of the urinary tract which impedes the flow of urine
Dx

For acute kidney injury:

  • Elevated BUN and creatinine
  • Decreased/absent urine production

For chronic kidney disease:

  • Determined by a decrease in GFR (i.e. rate at which blood is filtered in the kidney's glomeruli), which is detected by:
    • Decreased/absent urine production
    • Increase of waste products (creatinine or urea) in blood
Prognosis
  • Long term kidney problems associated with cardiovascular disease
Tx

For acute kidney injury:

  • Renal replacement therapy
  • Tx of underlying disorder

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Definition of Renal failure | Autoprac


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