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Renal Failure

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by

Joanie Manguino

on 25 June 2012

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Transcript of Renal Failure

Renal Failure There are 2 types of Renal Failure: Acute Renal Failure AKA Acute Kidney Injury Chronic Kidney Disease What is Renal Failure? Renal failure is when the kidneys fail to adequately
filter toxins and waste products from the blood. Acute Kidney Injury Causes: Acute Kidney Injury has 3 main causes which are: Symptoms: Bloody stools
Breath odor
Bruising easily
Changes in mental status or mood
Decreased appetite
Decreased sensation, especially in the hands or feet
Fatigue
Flank pain (between the ribs and hips)
High blood pressure - Hypertension
Metallic taste in mouth
Nausea or vomiting, may last for days
Nosebleeds - Epistaxis
Persistent hiccups
Prolonged bleeding
Seizures
Swelling of the ankle, foot, and leg - Edema Urination changes:
Decrease in amount of urine
Excessive urination at night - nocturia
Urination stops completely - anuria A sudden, serious drop in blood flow to the kidneys Heavy blood loss
An injury
A bad blood infection (sepsis) can reduce blood flow to the kidneys.
Not enough fluid in the body (dehydration) also can harm the kidneys Damage from some medicines, poisons, or infections Most people don't have any kidney problems from taking medicines. But people who have serious, long-term health problems are more likely to have a kidney problem from medicines. Examples of medicines that can sometimes harm the kidneys include: Antibiotics, such as gentamicin (minor skin infections) and streptomycin (TB).
Pain medicines, such as aspirin and ibuprofen.
Some blood pressure medicines
The dyes used in some X-ray tests A sudden blockage that stops urine from flowing out of the kidneys Kidney stones
A tumor
An injury
An enlarged prostate gland can cause a blockage. (BPH - Benign Prostatic Hypertrophy) Treatment Medications to control blood potassium Treatments to balance the amount of fluids in your blood (cc) image by nuonsolarteam on Flickr Treatment for acute kidney injury involves identifying the illness or injury that originally damaged the kidneys. Treatment options will depend on what's causing the kidney failure. The doctor will also work to prevent complications and allow the kidneys time to heal. Treatments that help prevent complications include: Dehydration - Intravenous Fluids Too much water causes edema- Diuretics "water pills" to expel extra fluids Referred to a Nephrologist Kidneys may not filtering Potassium (K) from blood properly - Kayexalate, a medicine to prevent hyperalkemia, may be prescribed. Too much potassium in blood (hyperalkemia) can cause dangerous irregular heartbeats (arrhythmias) Medications to restore blood calcium levels If the levels of calcium in blood drop too low, the doctor may recommend an infusion of calcium. Dialysis If toxins build up in blood, patient may need to undergo temporary hemodialysis Diagnosis How is Acute Kidney Injury diagnosed? Acute Kidney Injury is diagnosed:

During a hospital stay for another cause -
In the hospital, tests done for other problems may find kidney failure

Not in the hospital but have symptoms of kidney failure -
The doctor will ask about symptoms, what medicines are taken, and what tests have been done. Symptoms can help point to the cause of the kidney problem.

Blood and urine tests can check how well kidneys are working -
A chemistry screen can show if there is normal levels of sodium (salt), potassium, and calcium.

By an ultrasound -
This imaging test lets the doctor see a picture of the kidney. Diet A special diet may need to be followed to keep the kidneys from working too hard.

Limit sodium, potassium, and phosphorus.
Since the kidneys cannot easily remove excess water, salt, or potassium, these may need to be consumed in limited quantities.

Too much phosphorus can leech calcium from the bones and cause osteoporosis and fractures. Chronic Kidney Disease Causes: Symptoms Diagnosis Treatment Chronic kidney disease sometimes results from primary diseases of the kidneys themselves or:

Type 1 and type 2 diabetes mellitus
- which is the leading cause of kidney disease in the United States.

High blood pressure (hypertension)

Glomerulonephritis
-the inflammation and damage of the filtration system of the kidneys, which can cause kidney failure.

Polycystic kidney disease
- a hereditary cause of chronic kidney disease where both kidneys have multiple cysts.

Use of analgesics (painkillers)
-such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy (kidney disease)

Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys
-causes ischemic nephropathy, which is another cause of progressive kidney damage.

Obstruction of the flow of urine
-by stones, an enlarged prostate (BPH), strictures (narrowings), or cancers may also cause kidney disease.

Other causes of chronic kidney disease include HIV infection, sickle cell disease, heroin abuse, kidney stones, chronic kidney infections, and certain cancers. Symptoms may include: Appetite Loss General ill feeling and fatigue Headaches (cephalalgia) Itching (pruritis) and dry skin Nausea Unexplained weight loss Bone Pain (osteodynia) Shortness of breath (SOB) Menstrual Period stops (amenorrhea) Swelling of feet and Hands (edema) Vomiting (emesis) usually in the morning Diagnosis of chronic kidney disease can be confirmed by: Blood tests that measure the amount of waste product buildup such as:

BUN - Blood, Urea, Nitrogen
Creatinine
GFR- Glomerular Filtration Rate Urine test (urinalysis) may be done to:

Measure the amount of protein (sign of kidney damage)
Detect the presence of abnormal cells
Measure electrocyte concentration Other tests:

Abdominal Ultrasound
Biopsy There is no cure for chronic kidney disease. The four goals of therapy are to:

slow the progression of disease;
treat underlying causes and contributing factors;
treat complications of disease; and
replace lost kidney function. Diet- a Dietician will help understand appropriate foods
essential for the slowing down the progression of disease
Salt ,potassium & phosphorus intake will be limited In end-stage kidney disease, kidney functions can be replaced only by dialysis or by kidney transplantation & unlike Acute Kidney Injury, Chronic Kidney Disease is irreversible. Chronic kidney disease occurs when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually, usually months to years. Chronic kidney disease is divided into five stages of increasing severity Acute kidney injury can be fatal and requires intensive treatment. However, acute kidney injury may be reversible. If you're otherwise in good health, you may recover normal kidney function. Acute Kidney Injury is a rapid loss of kidney function. Usually from a couple of hours to days.
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