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Acute Renal Failure

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by

W Casasola

on 28 January 2014

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Transcript of Acute Renal Failure

By: Wendy Casasola
HCS/436
Due: 1/26/14

Acute Renal Failure
Location and Size:
Acute Renal Failure
Kidney
Another primary supportive treatment of ARF is dialysis
Function:
Hemodialysis
Peritoneal Dialysis
Kidney
Transplantation
-located in the back
-about the size of a fist
-waste excretion
-water level balance
-blood pressure, RBC, & Acid regulation

What is a kidney
?
-bean-shaped organ
- part of the urinary system
-produce hormones
-absorbs minerals
-filters blood & produce urine

(McClellan)
-Hypertension
-It is estimated that there are between 11 to 30 million people with chronic kidney disease of any evidence of kidney disease in USA.
-It is estimated that currently there are over 1 million people worldwide who are alive on dialysis.
(McClellan)
(McClellan)
(McClellan)
fgggggrer
Blood in
Blood out
dialysate in
Diffusion
dialysate out
(McClellan)
water
toxins
(ARF) is the sudden, abrupt cessation of renal function related to trauma, stress, drugs, or anything that decreases blood flow to the kidneys causing disruptions in fluid electrolyte, acid-base balances, retention of nitrogenous waste products, increased serum creatinine levels, and decreased glomerular filtration rate (GFR).




Causes of Acute Renal Failure
Acute Renal Failure is devided into
-Pre- renal
-Intra-renal
-Post-renal
Failure depends on which portion of kidneys is affected
Risk Factors
-Hypovolemia

-Septicemia

-Nephrotoxic drugs or chemicals
(antibiotics, NSAIDs, Organic solvents, contrast dye, heavy metal

-Hemolytic transfusion reactions

-Shock

-Glomerular disease

-Urinary tract obstruction

-Debilitating or serious illness

-Decreased renal perfusion from Acute Myocardial Infarction,
heart failure, DIC, sepsis
Signs & Symptoms
-Sudden onset of oliguria progressing
to anuria

-Hypertension

-Restlessness, twitching, convulsions

-Headache, Nausea, Vomiting

-Weight gain

-Peripheral edema

-Lung crackles, rapid respirations

-Ammonia breath odor
Diagnostic & Laboratory Test
-History & Physical
-Urinalysis
-Urine Specific gravity
-BUN & Creatinine
-Serum electrolytes
-CBC
-Renal untrasound, KUB, Xrays, CT,
aororenal angiography, cystoscopy,
retrograde pyelography, renal biopsy

Therapeutic Interventions
Assess/monitor:

-Intake & Output

-Daily Weight

-ECG

-Serum Electrolytes

-Fluid overload: Peripheral & periorbital edema, Lung crackels, Dyspnea,
Distented neck veins, Hypertention

-For signs of fluid volume deficit during diuretic phase



Therapeutic Interventions Cont.
-IV isotonic fluids & plasma expanders, hypovolemia

-Dopamine (in low doses to promote renal perfusion)

-Loop or osmotic diuretics to decrease fluid retention

-Kayexalate, to treat elevated K+, Insulin

-Calcium to prevent bone demineralization

-Antihypertensives if hypertension present (clonidine)

CCB in AFR caused from nephrotoxic acute tubular necrosis (ATN)
Pharmacology
Complications of Acute Renal Failure
-Hyperkalemia

-Hypertension

-Hemorrhage

-Seizures

-Cardiac Dysrhythmias

-Pulmonary Edema

-Infection

-Metabolic Acidosis

-Uremia
Pre-Renal: Any condition that significantly reduces renal perfusion pressure and causes a decreased glomerular filtration rate and azotemia may cause prerenal kidney failure
Renal: Actual damage to the nephrons and renal parenchyma characterize intrarenal failure
Post-renal: caused by clinical conditions that cause obstruction to urine flow
Goal

-The goals for collaborative management are to identify people with increased risks of developing acute renal failure

-Provide early recognition and treatment, restore blood flow to kidneys, prevent complications such as permanent injury, (pulmonary edema, heart failure, anemia, encephalopathy) and prevent recurrence.

References
"Acute Renal Failure." WebMD. WebMD, LLC., Jan 4, 2014. Retrieved from:

Copstead, L. C., & Banasik, J. L. (2010). Pathophysiology (5th ed.). St. Louis, MO: Saunders Elsevier.

Mayo Clinic Staff. “Acute Kidney Failure." Mayo Foundation for Medical Education and
Research, 2008. Retrieved from Web. January 4, 2014.

McClellan, William. "National Kidney and Urologic Diseases Information Clearinghouse."
National Institutes of Health, 2012. Web. 24 November 2012.

Shroff, Dr. Sunil. "Donate Organs to Save Lives” Web. December 28, 2013. Retrieved from:
http://www.futuremedicineonline.com/detail_news.php?id=285


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